Full Text Available The Primary Care Informatics Working Group (PCIWG of the American Medical Informatics Association (AMIA has identified the absence of a national strategy for primary care informatics. Under PCIWG leadership, major national and international societies have come together to create the National Alliance for Primary Care Informatics (NAPCI, to promote a connection between the informatics community and the organisations that support primary care. The PCIWG clinical practice subcommittee has recognised the necessity of a global needs assessment, and proposed work in point-of-care technology, clinical vocabularies, and ambulatory electronic medical record development. Educational needs include a consensus statement on informatics competencies, recommendations for curriculum and teaching methods, and methodologies to evaluate their effectiveness. The research subcommittee seeks to define a primary care informatics research agenda, and to support and disseminate informatics research throughout the primary care community. The AMIA board of directors has enthusiastically endorsed the conceptual basis for this White Paper.
Shortliffe, Edward H.; Bates, David W.; Bloomrosen, Meryl; Greenwood, Karen; Safran, Charles; Steen, Elaine B.; Tang, Paul C.; Williamson, Jeffrey J.
Don E. Detmer has served as President and Chief Executive Officer of the American Medical Informatics Association (AMIA) for the past five years, helping to set a course for the organization and demonstrating remarkable leadership as AMIA has evolved into a vibrant and influential professional association. On the occasion of Dr. Detmer's retirement, we fondly reflect on his professional life and his many contributions to biomedical informatics and, more generally, to health care in the U.S. and globally. PMID:19574463
Bouhaddou, O; Bennani Othmani, M; Diouny, S
Informatics is an essential tool for helping to transform healthcare from a paper-based to a digital sector. This article explores the state-of-the-art of health informatics in Morocco. Specifically, it aims to give a general overview of the Moroccan healthcare system, the challenges it is facing, and the efforts undertaken by the informatics community and Moroccan government in terms of education, research and practice to reform the country's health sector. Through the experience of establishing Medical Informatics as a medical specialty in 2008, creating a Moroccan Medical Informatics Association in 2010 and holding a first national congress took place in April 2012, the authors present their assessment of some important priorities for health informatics in Morocco. These Moroccan initiatives are facilitating collaboration in education, research, and implementation of clinical information systems. In particular, the stakeholders have recognized the need for a national coordinator office and the development of a national framework for standards and interoperability. For developing countries like Morocco, new health IT approaches like mobile health and trans-media health advertising could help optimize scarce resources, improve access to rural areas and focus on the most prevalent health problems, optimizing health care access, quality, and cost for Morocco population.
This Brief highlights Informatics and related techniques to Computer Science Professionals, Engineers, Medical Doctors, Bioinformatics researchers and other interdisciplinary researchers. Chapters include the Bioinformatics of Diabetes and several computational algorithms and statistical analysis approach to effectively study the disorders and possible causes along with medical applications.
van Ooijen, Peter; Glaudemans, Andor W.J.M.; Medema, Jitze; van Zanten, Annie K.; Dierckx, Rudi A.J.O.; Ahaus, C.T.B. (Kees)
Medical imaging informatics is gaining importance in medicine both in clinical practice and in scientific research. Besides radiology, nuclear medicine is also a major stakeholder in medical imaging informatics because of the variety of available imaging modalities and the imaging-oriented operation
Arokiasamy, J.; Ball, M.; Barnett, D.; Bearman, M.; Bemmel van, J.; Douglas, J.; Fisher, P.; Garrie, R.; Gatewood, L.; Goossen, W.; Grant, A.; Hales, J.; Hasman, A.; Haux, R.; Hovenga, E.; Johns, M.; Knaup, P.; Leven, F. J.; Lorenzi, N.; Murray, P.; Neame, R.; Protti, D.; Power, M.; Richard, J.; Schuster, E.; Swinkels, W.; Yang, J.; Zelmer, L.; Zvárová, Jana
Roč. 40, č. 5 (2001), s. 267-277 ISSN 0026-1270 Institutional research plan: AV0Z1030915 Keywords : health informatics * medical informatics * education * recommendations * International Medical Informatics Association * IMIA Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 1.254, year: 2001
Medical Imaging Informatics has become a fast evolving discipline at the crossing of Informatics, Computational Sciences, and Medicine that is profoundly changing medical practices, for the patients' benefit.
Arocha José F
Full Text Available Abstract Background The "applied" nature distinguishes applied sciences from theoretical sciences. To emphasize this distinction, we begin with a general, meta-level overview of the scientific endeavor. We introduce the knowledge spectrum and four interconnected modalities of knowledge. In addition to the traditional differentiation between implicit and explicit knowledge we outline the concepts of general and individual knowledge. We connect general knowledge with the "frame problem," a fundamental issue of artificial intelligence, and individual knowledge with another important paradigm of artificial intelligence, case-based reasoning, a method of individual knowledge processing that aims at solving new problems based on the solutions to similar past problems. We outline the fundamental differences between Medical Informatics and theoretical sciences and propose that Medical Informatics research should advance individual knowledge processing (case-based reasoning and that natural language processing research is an important step towards this goal that may have ethical implications for patient-centered health medicine. Discussion We focus on fundamental aspects of decision-making, which connect human expertise with individual knowledge processing. We continue with a knowledge spectrum perspective on biomedical knowledge and conclude that case-based reasoning is the paradigm that can advance towards personalized healthcare and that can enable the education of patients and providers. We center the discussion on formal methods of knowledge representation around the frame problem. We propose a context-dependent view on the notion of "meaning" and advocate the need for case-based reasoning research and natural language processing. In the context of memory based knowledge processing, pattern recognition, comparison and analogy-making, we conclude that while humans seem to naturally support the case-based reasoning paradigm (memory of past experiences
D'Avolio, Leonard W; Farwell, Wildon R; Fiore, Louis D
As is the case for environmental, ecological, astronomical, and other sciences, medical practice and research finds itself in a tsunami of data. This data deluge, due primarily to the introduction of digitalization in routine medical care and medical research, affords the opportunity for improved patient care and scientific discovery. Medical informatics is the subdiscipline of medicine created to make greater use of information in order to improve healthcare. The 4 areas of medical informatics research (information access, structure, analysis, and interaction) are used as a framework to discuss the overlap in information needs of comparative effectiveness research and potential contributions of medical informatics. Examples of progress from the medical informatics literature and the Veterans Affairs Healthcare System are provided. Published by Elsevier Inc.
Full Text Available The article describes the state and some trends in the development of medical informatics especially regarding the fields of scientific information, knowledge discovery in databases, and the role of standards in data exchange.The ways of publication of scientific documents experienced dramatic changes with the development of the www, hence causing major changes in daily information practice. Contemporary textual databases contain full documents of hypertextual and multimedia nature and links to full documents are increasingly common within the records of bibliographic databases. The last decade brought the advent of the web information tools, from web portals to global search engines, which are powerful aids but demand strong precaution regarding the quality of retrieved documents from the users. On the other hand, we are witnessing the development of digital libraries of scientific documents as a result of the self-organization of academic institutions, research groups and individuals, often in the opposition to the interests of publishing companies.The information support as an important element of medical procedures made possible the exchange of data between all segments of the health-care system and it has become clear that lack of standards governing structure, understanding and safety is among the biggest obstacles to successful data exchange.In addition, the article comprises a report on the methods of knowledge discovery in databases, which help us discover hidden structures and potential knowledge, invisible to the normal data-processing software, in the enormous amount of data.
Henricks, Walter H; Karcher, Donald S; Harrison, James H; Sinard, John H; Riben, Michael W; Boyer, Philip J; Plath, Sue; Thompson, Arlene; Pantanowitz, Liron
Context: Recognition of the importance of informatics to the practice of pathology has surged. Training residents in pathology informatics have been a daunting task for most residency programs in the United States because faculty often lacks experience and training resources. Nevertheless, developing resident competence in informatics is essential for the future of pathology as a specialty. Objective: The objective of the study is to develop and deliver a pathology informatics curriculum and instructional framework that guides pathology residency programs in training residents in critical pathology informatics knowledge and skills and meets Accreditation Council for Graduate Medical Education Informatics Milestones. Design: The College of American Pathologists, Association of Pathology Chairs, and Association for Pathology Informatics formed a partnership and expert work group to identify critical pathology informatics training outcomes and to create a highly adaptable curriculum and instructional approach, supported by a multiyear change management strategy. Results: Pathology Informatics Essentials for Residents (PIER) is a rigorous approach for educating all pathology residents in important pathology informatics knowledge and skills. PIER includes an instructional resource guide and toolkit for incorporating informatics training into residency programs that vary in needs, size, settings, and resources. PIER is available at http://www.apcprods.org/PIER (accessed April 6, 2016). Conclusions: PIER is an important contribution to informatics training in pathology residency programs. PIER introduces pathology trainees to broadly useful informatics concepts and tools that are relevant to practice. PIER provides residency program directors with a means to implement a standardized informatics training curriculum, to adapt the approach to local program needs, and to evaluate resident performance and progress over time. PMID:27563486
Chouvarda, I; Maglaveras, N
This paper aims to present an overview of the medical informatics landscape in Greece, to describe the Greek ehealth background and to highlight the main education and research axes in medical informatics, along with activities, achievements and pitfalls. With respect to research and education, formal and informal sources were investigated and information was collected and presented in a qualitative manner, including also quantitative indicators when possible. Greece has adopted and applied medical informatics education in various ways, including undergraduate courses in health sciences schools as well as multidisciplinary postgraduate courses. There is a continuous research effort, and large participation in EU-wide initiatives, in all the spectrum of medical informatics research, with notable scientific contributions, although technology maturation is not without barriers. Wide-scale deployment of eHealth is anticipated in the healthcare system in the near future. While ePrescription deployment has been an important step, ICT for integrated care and telehealth have a lot of room for further deployment. Greece is a valuable contributor in the European medical informatics arena, and has the potential to offer more as long as the barriers of research and innovation fragmentation are addressed and alleviated.
Mantas, John; Ammenwerth, Elske; Demiris, George; Hasman, Arie; Haux, Reinhold; Hersh, William; Hovenga, Evelyn; Lun, K. C.; Marin, Heimar; Martin-Sanchez, Fernando; Wright, Graham
Objective: The International Medical Informatics Association (IMIA) agreed on revising the existing international recommendations in health informatics/medical informatics education. These should help to establish courses, course tracks or even complete programs in this field, to further develop
Huang, H K; Wong, S T; Pietka, E
Picture archiving and communication systems (PACS) is a system integration of multimodality images and health information systems designed for improving the operation of a radiology department. As it evolves, PACS becomes a hospital image document management system with a voluminous image and related data file repository. A medical image informatics infrastructure can be designed to take advantage of existing data, providing PACS with add-on value for health care service, research, and education. A medical image informatics infrastructure (MIII) consists of the following components: medical images and associated data (including PACS database), image processing, data/knowledge base management, visualization, graphic user interface, communication networking, and application oriented software. This paper describes these components and their logical connection, and illustrates some applications based on the concept of the MIII.
Suárez-Obando, Fernando; Camacho Sánchez, Jhon
The use of computers in medical practice has enabled novel forms of communication to be developed in health care. The optimization of communication processes is achieved through the use of standards to harmonize the exchange of information and provide a common language for all those involved. This article describes the concept of a standard applied to medical informatics and its importance in the development of various applications, such as computational representation of medical knowledge, disease classification and coding systems, medical literature searches and integration of biological and clinical sciences. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.
In the era of digitization some new procedures play an increasing role for diagnosis as well as for therapy: informatics diagnostics and informatics therapeutics. Challenges for such procedures are described. It is discussed, when research on such diagnostics and therapeutics can be regarded as good research. Examples are mentioned for informatics diagnostics and informatics therapeutics, which are based on health-enabling technologies.
This project built a medical informatics data warehouse (MedInfo DDW) in an Oracle database to analyze medical information which has been collected through Baylor Family Medicine Clinic (FCM) Logician application. The MedInfo DDW used Star Schema with dimensional model, FCM database as operational data store (ODS); the data from on-line transaction processing (OLTP) were extracted and transferred to a knowledge based data warehouse through SQLLoad, and the patient information was analyzed by using on-line analytic processing (OLAP) in Crystal Report.
Roger, F H; Behets, M; Andre, J; de Moor, G; Sevens, C; Willems, J L
The Belgian Society for Medical Informatics (MIM) organized a survey in 1986 in order to assess the present state of development of medical informatics in Belgium. Questionnaires were sent to hospitals, laboratories, private practitioners and pharmacists, as well as to social security organizations and software industries. The response rate was higher in hospitals (93%) than in any other category. Results showed a large number of computerized hospitals (93% of general acute care hospitals and 91% of psychiatric hospitals). There has been a sharp increase (+ 15%) in computerization of the admission, accounting and billing procedures since 1985, most likely in relation with administrative rules issued by the Belgian Government. The same trend (+ 20%) has been observed for computer applications in clinical laboratories, between 1984 and 1985. There is almost one computer terminal for ten beds in the hospitals with more than 200 beds in 1986. This figure exemplifies the present trend to on-line access to data. Computerized instrumental aids to medicine such as text processing, imaging or computerized interpretation of signals have known a rapid extension during recent years, although less comprehensive than administrative applications in hospitals and in social security organizations. The present state of other applications in medicine (general practice, pharmacy, etc.) was more difficult to assess as those information systems remain more pinpointed. In all medical fields, there appears to be a new rise in computer programs offered by software companies.
Hucíková, Anežka; Babic, Ankica
YouTube as an online video-sharing service in the context of Web 2.0 goes beyond the bounds of pure fun, for which the platform was primarily established. Nowadays, commonly to other social media, it serves also educational, informational and last but not least, marketing purposes. The importance of video sharing is supported by several predictions about video reaching over 90% of global internet traffic by 2020. Using qualitative content analysis over selected YouTube videos, paper examines the current situation of the platform's marketing potential usage by medical informatics organizations, researches and other healthcare professionals. Results of the analysis demonstrate several ways in which YouTube is already used to inform, educate or promote above-mentioned medical institutions. However, their engagement in self-promo or spreading awareness of their research projects via YouTube is considered to be low.
Full Text Available The article reviews features of teaching Medical Informatics and Statistics. The course is referred to the disciplines of Mathematical and Natural sciences. The course is provided in all the faculties of I. M. Sechenov First Moscow State Medical University. For students of Preventive Medicine Department the time frame allotted for studying the course is significantly larger than for similar course provided at other faculties. To improve the teaching methodology of the discipline an analysis of the curriculum has been carried out, attendance and students’ performance statistics have been summarized. As a result, the main goals and objectives have been identified. Besides, general educational functions and the contribution to the solution of problems of education, students’ upbringing and development have been revealed; two stages of teaching have been presented. Recommendations referred to the newest methodological development aimed at improving the quality of teaching the discipline are provided. The ways of improving the methods and organizational forms of education are outlined.
Huang, H K
Historical reviews of PACS (picture archiving and communication system) and imaging informatics development from different points of view have been published in the past (Huang in Euro J Radiol 78:163-176, 2011; Lemke in Euro J Radiol 78:177-183, 2011; Inamura and Jong in Euro J Radiol 78:184-189, 2011). This retrospective attempts to look at the topic from a different angle by identifying certain basic medical imaging inventions in the 1960s and 1970s which had conceptually defined basic components of PACS guiding its course of development in the 1980s and 1990s, as well as subsequent imaging informatics research in the 2000s. In medical imaging, the emphasis was on the innovations at Georgetown University in Washington, DC, in the 1960s and 1970s. During the 1980s and 1990s, research and training support from US government agencies and public and private medical imaging manufacturers became available for training of young talents in biomedical physics and for developing the key components required for PACS development. In the 2000s, computer hardware and software as well as communication networks advanced by leaps and bounds, opening the door for medical imaging informatics to flourish. Because many key components required for the PACS operation were developed by the UCLA PACS Team and its collaborative partners in the 1980s, this presentation is centered on that aspect. During this period, substantial collaborative research efforts by many individual teams in the US and in Japan were highlighted. Credits are due particularly to the Pattern Recognition Laboratory at Georgetown University, and the computed radiography (CR) development at the Fuji Electric Corp. in collaboration with Stanford University in the 1970s; the Image Processing Laboratory at UCLA in the 1980s-1990s; as well as the early PACS development at the Hokkaido University, Sapporo, Japan, in the late 1970s, and film scanner and digital radiography developed by Konishiroku Photo Ind. Co. Ltd
Roč. 50, - (1998), s. 219-223 ISSN 1386-5056 Keywords : information technologies * education * training * medical informatics * medical statistics * epidemiology Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 0.357, year: 1998
e-Health is experiencing a difficult time. On the one side, the forecast is for a bright digital health future created by precision medicine and smart devices. On the other hand, most large scale e-health projects struggle to make a difference and are often controversial. Both futures fail because they are not evidence-based. Medical informatics should follow the example of evidence-based medicine, i.e. conduct rigorous research that gives us evidence to solve real world problems, synthesise that evidence and then apply it strictly. We already have the tools for creating a different universe. What we need is evidence, will, a culture of learning, and hard work.
Huang, H K; Deshpande, Ruchi; Documet, Jorge; Le, Anh H; Lee, Jasper; Ma, Kevin; Liu, Brent J
A medical imaging informatics infrastructure (MIII) platform is an organized method of selecting tools and synthesizing data from HIS/RIS/PACS/ePR systems with the aim of developing an imaging-based diagnosis or treatment system. Evaluation and analysis of these systems can be made more efficient by designing and implementing imaging informatics simulators. This tutorial introduces the MIII platform and provides the definition of treatment/diagnosis systems, while primarily focusing on the development of the related simulators. A medical imaging informatics (MII) simulator in this context is defined as a system integration of many selected imaging and data components from the MIII platform and clinical treatment protocols, which can be used to simulate patient workflow and data flow starting from diagnostic procedures to the completion of treatment. In these processes, DICOM and HL-7 standards, IHE workflow profiles, and Web-based tools are emphasized. From the information collected in the database of a specific simulator, evidence-based medicine can be hypothesized to choose and integrate optimal clinical decision support components. Other relevant, selected clinical resources in addition to data and tools from the HIS/RIS/PACS and ePRs platform may also be tailored to develop the simulator. These resources can include image content indexing, 3D rendering with visualization, data grid and cloud computing, computer-aided diagnosis (CAD) methods, specialized image-assisted surgical, and radiation therapy technologies. Five simulators will be discussed in this tutorial. The PACS-ePR simulator with image distribution is the cradle of the other simulators. It supplies the necessary PACS-based ingredients and data security for the development of four other simulators: the data grid simulator for molecular imaging, CAD-PACS, radiation therapy simulator, and image-assisted surgery simulator. The purpose and benefits of each simulator with respect to its clinical relevance
Academic Medicine, 1999
The report of the Association of American Medical Colleges' Medical School Objectives Program presents the work of two expert panels. One, on medical informatics, identified five important physician roles: lifelong learner, clinician, educator, researcher, and manager. Another panel established a definition for "population health…
Hu, Dehua; Sun, Zhenling; Li, Houqing
To outline the history of medical informatics education in the People's Republic of China, systematically analyze the current status of medical informatics education at different academic levels (bachelor's, master's, and doctoral), and suggest reasonable strategies for the further development of the field in China. The development of medical informatics education was divided into three stages, defined by changes in the specialty's name. Systematic searches of websites for material related to the specialty of medical informatics were then conducted. For undergraduate education, the websites surveyed included the website of the Ministry of Education of the People's Republic of China (MOE) and those of universities or colleges identified using the baidu.com search engine. For postgraduate education, the websites included China's Graduate Admissions Information Network (CGAIN) and the websites of the universities or their schools or faculties. Specialties were selected on the basis of three criteria: (1) for undergraduate education, the name of specialty or program was medical informatics or medical information or information management and information system; for postgraduate education, medical informatics or medical information; (2) the specialty was approved and listed by the MOE; (3) the specialty was set up by a medical college or medical university, or a school of medicine of a comprehensive university. The information abstracted from the websites included the year of program approval and listing, the university/college, discipline catalog, discipline, specialty, specialty code, objectives, and main courses. A total of 55 program offerings for undergraduate education, 27 for master's-level education, and 5 for PhD-level education in medical informatics were identified and assessed in China. The results indicate that medical informatics education, a specialty rooted in medical library and information science education in China, has grown significantly in that
Ma, Xiaoyan; Han, Zhongdong; Ma, Hua
This article aims at clarifying the strategic significance of developing medical informatics, conducting SWOT analysis on this discipline and hence establishing the strategic objectives and focal points for its development.
Morris, Theodore A.; McCain, Katherine W.
Abstract Objective: Medical informatics is an emergent interdisciplinary field described as drawing upon and contributing to both the health sciences and information sciences. The authors elucidate the disciplinary nature and internal structure of the field. Design: To better understand the field's disciplinary nature, the authors examine the intercitation relationships of its journal literature. To determine its internal structure, they examined its journal cocitation patterns. Measurements: The authors used data from the Science Citation Index (SCI) and Social Science Citation Index (SSCI) to perform intercitation studies among productive journal titles, and software routines from SPSS to perform multivariate data analyses on cocitation data for proposed core journals. Results: Intercitation network analysis suggests that a core literature exists, one mark of a separate discipline. Multivariate analyses of cocitation data suggest that major focus areas within the field include biomedical engineering, biomedical computing, decision support, and education. The interpretable dimensions of multidimensional scaling maps differed for the SCI and SSCI data sets. Strong links to information science literature were not found. Conclusion: The authors saw indications of a core literature and of several major research fronts. The field appears to be viewed differently by authors writing in journals indexed by SCI from those writing in journals indexed by SSCI, with more emphasis placed on computers and engineering versus decision making by the former and more emphasis on theory versus application (clinical practice) by the latter. PMID:9760393
The health informatics profession in Bosnia and Herzegovina has relatively long history. Thirty five years from the introduction of the first automatic manipulation of data, thirty years from the establishment of Society for Medical Informatics BiH, twenty years from the establishment of the Scientific journal "Acta Informatica Medica (Acta Inform Med", indexed in PubMed, PubMed Central Scopus, Embase, etc.), twenty years on from the establishment of the first Cathedra for Medical Informatics on Biomedical Faculties in Bosnia and Herzegovina, ten years on from the introduction of the method of "Distance learning" in medical curriculum. The author of this article is eager to mark the importance of the above mentioned Anniversaries in the development of Health informatics in Bosnia and Herzegovina and have attempted, very briefly, to present the most significant events and persons with essential roles throughout this period.
Hercigonja-Szekeres, Mira; Simić, Diana; Božikov, Jadranka; Vondra, Petra
Paper presents an overview of the EU funded Project of Curriculum Development for Interdisciplinary Postgraduate Specialist Study in Medical Informatics named MEDINFO to be introduced in Croatia. The target group for the program is formed by professionals in any of the areas of medicine, IT professionals working on applications of IT for health and researchers and teachers in medical informatics. In addition to Croatian students, the program will also provide opportunity for enrolling students from a wider region of Southeast Europe. Project partners are two faculties of the University of Zagreb - Faculty of Organization and Informatics from Varaždin and School of Medicine, Andrija Štampar School of Public Health from Zagreb with the Croatian Society for Medical Informatics, Croatian Chamber of Economy, and Ericsson Nikola Tesla Company as associates.
Sarachan, B D; Simmons, M K; Subramanian, P; Temkin, J M
Key bioinformatics and medical informatics research areas need to be identified to advance knowledge and understanding of disease risk factors and molecular disease pathology in the 21 st century toward new diagnoses, prognoses, and treatments. Three high-impact informatics areas are identified: predictive medicine (to identify significant correlations within clinical data using statistical and artificial intelligence methods), along with pathway informatics and cellular simulations (that combine biological knowledge with advanced informatics to elucidate molecular disease pathology). Initial predictive models have been developed for a pilot study in Huntington's disease. An initial bioinformatics platform has been developed for the reconstruction and analysis of pathways, and work has begun on pathway simulation. A bioinformatics research program has been established at GE Global Research Center as an important technology toward next generation medical diagnostics. We anticipate that 21 st century medical research will be a combination of informatics tools with traditional biology wet lab research, and that this will translate to increased use of informatics techniques in the clinic.
Time of information in which the authors live resulted in the increase of the amount of the information exponential growth of the new kind of knowledge, flourishing of the familiar ones and the appearance of the new sciences. Medical (health) informatics occupies the central place in all the segments of modern medicine in the past 30 years--in practical work, education and scientific research. In all that, computers have taken over the most important role and are used intensively for the development of the health information systems. Following activities develop within the area of health informatics: health-documentation, health-statistics, health-informatics and bio-medical, scientific and professional information. The pioneer in the development of the health statistics and informatics in Bosnia and Herzegovina (BiH) was Dr Evgenije Sherstnew, who was the Chief of Health Statistics in the Ministry of Health of BiH from 1946-1952, and who founded and led, from 1952 to the end of his life, the Department of Medical Documentation and Health Statistics of the Central Health Institute of BiH, the core around which a group of experts for the development of this field have gathered. In the eighties computers were intensively used as a tool for the processing medical data and with them the development of health information systems at the level of the outpatient-clinics, hospitals, clinical centers, as well as the integral information system of health, health insurance and the social security system of BiH began. Finally, Society for Medical Informatics of BiH, which as a professional association gathers experts in the area of health informatics, actively propagates this profession in the Republic, was founded. With reform of the lectures and curriculum at the medical faculty in Sarajevo, the course in 'Medical Informatics' has been in 1992. into the second semester, since it was assumed that an early insight into the principles of information along with studies of so
Full Text Available Newer healthcare technologies and treatment procedures are being developed rapidly, and clinicians are incorporating them into their daily practice. They are integrating the past and the present knowledge for better patient healthcare. Previously, it had been difficult to organize, store and retrieve medical and patient information. But, today, with the advent of computers and, moreover, information technology has led to the development of medical informatics that is helping physicians to overcome these challenges. Medical informatics deals with all aspects of understanding and promoting the effective organization analysis, management and use of information in healthcare, which are being highlighted in this review paper.
Phillips, M; Kalet, I; McNutt, T; Smith, W
Biomedical informatics encompasses a very large domain of knowledge and applications. This broad and loosely defined field can make it difficult to navigate. Physicists often are called upon to provide informatics services and/or to take part in projects involving principles of the field. The purpose of the presentations in this symposium is to help medical physicists gain some knowledge about the breadth of the field and how, in the current clinical and research environment, they can participate and contribute. Three talks have been designed to give an overview from the perspective of physicists and to provide a more in-depth discussion in two areas. One of the primary purposes, and the main subject of the first talk, is to help physicists achieve a perspective about the range of the topics and concepts that fall under the heading of 'informatics'. The approach is to de-mystify topics and jargon and to help physicists find resources in the field should they need them. The other talks explore two areas of biomedical informatics in more depth. The goal is to highlight two domains of intense current interest--databases and models--in enough depth into current approaches so that an adequate background for independent inquiry is achieved. These two areas will serve as good examples of how physicists, using informatics principles, can contribute to oncology practice and research. Learning Objectives: To understand how the principles of biomedical informatics are used by medical physicists. To put the relevant informatics concepts in perspective with regard to biomedicine in general. To use clinical database design as an example of biomedical informatics. To provide a solid background into the problems and issues of the design and use of data and databases in radiation oncology. To use modeling in the service of decision support systems as an example of modeling methods and data use. To provide a background into how uncertainty in our data and knowledge can be
Roč. 9, - (2005), s. 269-274 ISSN 1335-2393. [YBERC 2005. Young Biomedical Engineers and Researchers Conference. Stará Lesná, 13.07.2005-15.07.2005] Institutional research plan: CEZ:AV0Z10300504 Keywords : medical informatics * information society * telemedicine * education * research and development Subject RIV: BD - Theory of Information
The open access paradigm has become an important approach in today's information and communication society. Funders and governments in different countries stipulate open access publications of funded research results. Medical informatics as part of the science, technology and medicine disciplines benefits from many research funds, such as National Institutes of Health in the US, Wellcome Trust in UK, German Research Foundation in Germany and many more. In this study an overview of the current open access programs and conditions of major journals in the field of medical informatics is presented. It was investigated whether there are suitable options and how they are shaped. Therefore all journals in Thomson Reuters Web of Science that were listed in the subject category "Medical Informatics" in 2014 were examined. An Internet research was conducted by investigating the journals' websites. It was reviewed whether journals offer an open access option with a subsequent check of conditions as for example the type of open access, the fees and the licensing. As a result all journals in the field of medical informatics that had an impact factor in 2014 offer an open access option. A predominantly consistent pricing range was determined with an average fee of 2.248 € and a median fee of 2.207 €. The height of a journals' open access fee did not correlate with the height of its Impact Factor. Hence, medical informatics journals have recognized the trend of open access publishing, though the vast majority of them are working with the hybrid method. Hybrid open access may however lead to problems in questions of double dipping and the often stipulated gold open access.
Röhrig, R; Stausberg, J; Dugas, M
The aim of this project is to develop a catalogue of competency-based learning objectives "Medical Informatics" for undergraduate medical education (abbreviated NKLM-MI in German). The development followed a multi-level annotation and consensus process. For each learning objective a reason why a physician needs this competence was required. In addition, each objective was categorized according to the competence context (A = covered by medical informatics, B = core subject of medical informatics, C = optional subject of medical informatics), the competence level (1 = referenced knowledge, 2 = applied knowledge, 3 = routine knowledge) and a CanMEDS competence role (medical expert, communicator, collaborator, manager, health advocate, professional, scholar). Overall 42 objectives in seven areas (medical documentation and information processing, medical classifications and terminologies, information systems in healthcare, health telematics and telemedicine, data protection and security, access to medical knowledge and medical signal-/image processing) were identified, defined and consented. With the NKLM-MI the competences in the field of medical informatics vital to a first year resident physician are identified, defined and operationalized. These competencies are consistent with the recommendations of the International Medical Informatics Association (IMIA). The NKLM-MI will be submitted to the National Competence-Based Learning Objectives for Undergraduate Medical Education. The next step is implementation of these objectives by the faculties.
Perry, Gerald J; Roderer, Nancy K; Assar, Soraya
The article offers a current perspective on medical informatics and health sciences librarianship. The authors: (1) discuss how definitions of medical informatics have changed in relation to health sciences librarianship and the broader domain of information science; (2) compare the missions of health sciences librarianship and health sciences informatics, reviewing the characteristics of both disciplines; (3) propose a new definition of health sciences informatics; (4) consider the research agendas of both disciplines and the possibility that they have merged; and (5) conclude with some comments about actions and roles for health sciences librarians to flourish in the biomedical information environment of today and tomorrow. Boundaries are disappearing between the sources and types of and uses for health information managed by informaticians and librarians. Definitions of the professional domains of each have been impacted by these changes in information. Evolving definitions reflect the increasingly overlapping research agendas of both disciplines. Professionals in these disciplines are increasingly functioning collaboratively as "boundary spanners," incorporating human factors that unite technology with health care delivery.
respect to Medical Physics, and conversely see how Informatics may assist the medical physicist in filling some of the current gaps in their activities. 3. Understand general informatics concepts and areas of investigation including imaging and workflow standards, systems integration, computing architectures, ontologies, data mining and business analytics, data visualization and human-computer interface tools, and the importance of quantitative imaging for the future of Medical Physics and Imaging Informatics. 4. Become familiar with on-going efforts to address current challenges facing future research into and clinical implementation of quantitative imaging applications. © 2012 American Association of Physicists in Medicine.
Mattheus, Rudy A.
A summary of the CEN TC 251/4 ''Medical Imaging and Multi-Media'' activities will be given. CEN is the European standardization institute, TC 251 deals with medical informatics. Standardization is a condition for the wide scale use of health care and medical informatics and for the creation of a common market. In the last two years, three important categories-- namely, the Commission of the European Communities with their programs and the mandates, the medical informaticians through their European professional federation, and the national normalization institutes through the European committee--have shown to be aware of this problem and have taken actions. As a result, a number of AIM (Advanced Informatics in Medicine), CEC sponsored projects, the CEC mandates to CEN and EWOS, the EFMI working group on standardization, the technical committee of CEN, and the working groups and project teams of CEN and EWOS are working on the subject. On overview of the CEN TC 251/4 ''Medical Imaging and Multi-Media'' activities will be given, including their relation to other work.
The paper describes the history of medical informatics in Czechoslovakia and the Czech Republic. It focuses on the topics of medical informatics education and decision support methods and systems. Several conferences held in Czechoslovakia and in the Czech Republic organized in cooperation with IMIA or EFMI are described. Support of European Union and Czech agencies in several European and national projects focused on medical informatics topics highly contributed to medical informatics development in Czechoslovakia and the Czech Republic and to the establishment of the European Center for Medical Informatics, Statistics and Epidemiology as the joint workplace of Charles University in Prague and Academy of Sciences of the Czech Republic in 1994.
Computers, like the X-ray and stethoscope can be seen as clinical tools, that provide physicians with improved expertise in solving patient management problems. As tools they enable us to extend our clinical information base, and they also provide facilities that improve the delivery of the health care we provide. Automation (computerisation) in the health domain will cause the computer to become a more integral part of health care management and delivery before the start of the next century. To understand how the computer assists those who deliver and manage health care, it is important to be aware of its functional capabilities and how we can use them in medical practice. The rapid technological advances in computers over the last two decades has had both beneficial and counterproductive effects on the implementation of effective computer applications in the delivery of health care. For example, in the 1990s the computer hobbyist is able to make an investment of less than $10,000 on computer hardware that will match or exceed the technological capacities of machines of the 1960s. These rapid technological advances, which have produced a quantum leap in our ability to store and process information, have tended to make us overlook the need for effective computer programmes which will meet the needs of patient care. As the 1990s begin, those delivering health care (eg, physicians, nurses, pharmacists, administrators ...) need to become more involved in directing the effective implementation of computer applications that will provide the tools for improved information management, knowledge processing, and ultimately better patient care.
Dezelic, Gjuro; Kern, Josipa; Petrovecki, Mladen; Ilakovac, Vesna; Hercigonja-Szekeres, Mira
A historical survey of medical informatics (MI) in Croatia is presented from the beginnings in the late sixties of the 20th century to the present time. Described are MI projects, applications in clinical medicine and public health, start and development of MI research and education, beginnings of international cooperation, establishment of the Croatian Society for MI and its membership to EFMI and IMIA. The current status of computerization of the Croatian healthcare system is sketched as well as the present graduate and postgraduate study MI curricula. The information contained in the paper shows that MI in Croatia developed and still develops along with its advancement elsewhere. PMID:24648620
Haux, R.; Ammenwerth, E.; ter Burg, W. J.; Pilz, J.; Jaspers, M. W. M.
We report on a course for medical informatics students on hospital information systems, especially on its strategic information management. Starting as course at the Medical Informatics Program of the University of Heidelberg/University of Applied Sciences Heilbronn, it is now organized as
Nadri, Hamed; Rahimi, Bahlol; Timpka, Toomas; Sedghi, Shahram
The number of citations that a research paper receives can be used as a measure of its scientific impact. The objective of this study was to identify and to examine the characteristics of top 100 cited articles in the field of Medical Informatics based on data acquired from the Thomson Reuters' Web of Science (WOS) in October, 2016. The data was collected using two procedures: first we included articles published in the 24 journals listed in the "Medical Informatics" category; second, we retrieved articles using the key words: "informatics", "medical informatics", "biomedical informatics", "clinical informatics" and "health informatics". After removing duplicate records, articles were ranked by the number of citations they received. When the 100 top cited articles had been identified, we collected the following information for each record: all WOS database citations, year of publication, journal, author names, authors' affiliation, country of origin and topics indexed for each record. Citations for the top 100 articles ranged from 346 to 7875, and citations per year ranged from 11.12 to 525. The majority of articles were published in the 2000s (n=43) and 1990s (n=38). Articles were published across 10 journals, most commonly Statistics in medicine (n=71) and Medical decision making (n=28). The articles had an average of 2.47 authors. Statistics and biostatistics modeling was the most common topic (n=71), followed by artificial intelligence (n=12), and medical errors (n=3), other topics included data mining, diagnosis, bioinformatics, information retrieval, and medical imaging. Our bibliometric analysis illustrated a historical perspective on the progress of scientific research on Medical Informatics. Moreover, the findings of the current study provide an insight on the frequency of citations for top cited articles published in Medical Informatics as well as quality of the works, journals, and the trends steering Medical Informatics.
NONE DECLARED LAST TWO YEARS, THE HEALTH INFORMATICS PROFESSION CELEBRATED FIVE JUBILEES IN BOSNIA AND HERZEGOVINA: thirty years from the introduction of the first automatic manipulation of data, twenty years from the establishment of Society for Medical Informatics BiH, fifteen years from the establishment of the Scientific and Professional Journal of the Society for Medical Informatics of Bosnia and Herzegovina "Acta Informatica Medica", fifteen years on from the establishment of the first Cathedra for Medical Informatics on Biomedical Faculties in Bosnia and Herzegovina and five years on from the introduction of the method of "Distance learning" in medical curriculum. The author of this article are eager to mark the importance of the above mentioned Anniversaries in the development of Health informatics in Bosnia and Herzegovina and have attempted, very briefly, to present the most significant events and persons with essential roles throughout this period.
Lyu, Peng-Hui; Yao, Qiang; Mao, Jin; Zhang, Shi-Jing
The aim of this study is to analyze the research trends of medical informatics over the last 12 years. A new method based on MeSH terms was proposed to identify emerging topics and trends of medical informatics research. Informetric methods and visualization technologies were applied to investigate research trends of medical informatics. The metric of perspective factor (PF) embedding MeSH terms was appropriately employed to assess the perspective quality for journals. The emerging MeSH terms have changed dramatically over the last 12 years, identifying two stages of medical informatics: the "medical imaging stage" and the "medical informatics stage". The focus of medical informatics has shifted from acquisition and storage of healthcare data by integrating computational, informational, cognitive and organizational sciences to semantic analysis for problem solving and clinical decision-making. About 30 core journals were determined by Bradford's Law in the last 3 years in this area. These journals, with high PF values, have relative high perspective quality and lead the trend of medical informatics.
Martin-Sanchez, F.; Iakovidis, I.; Norager, S.; Maojo, V.; de Groen, P.; Van der Lei, J.; Jones, T.; Abraham-Fuchs, K.; Apweiler, R.; Babic, A.; Baud, R.; Breton, V.; Cinquin, P.; Doupi, P.; Dugas, M.; Eils, R.; Engelbrecht, R.; Ghazal, P.; Jehenson, P.; Kulikowski, C.; Lampe, K.; De Moor, G.; Orphanoudakis, S.; Rossing, N.; Sarachan, B.; Sousa, A.; Spekowius, G.; Thireos, G.; Zahlmann, G.; Zvárová, Jana; Hermosilla, I.; Vicente, F. J.
Roč. 37, - (2004), s. 30-42 ISSN 1532-0464 Institutional research plan: CEZ:AV0Z1030915 Keywords : bioinformatics * medical informatics * genomics * genomic medicine * biomedical informatics Subject RIV: BD - Theory of Information Impact factor: 1.013, year: 2004
Prokosch, H U; Ganslandt, T
Even though today most university hospitals have already implemented commercial hospital information systems and started to build up comprehensive electronic medical records, reuse of such data for data warehousing and research purposes is still very rare. Given this situation, the focus of this paper is to present an overview on exemplary projects, which have already tackled this challenge, reflect on current initiatives within the United States of America and the European Union to establish IT infrastructures for clinical and translational research, and draw attention to new challenges in this area. This paper does not intend to provide a fully comprehensive review on all the issues of clinical routine data reuse. It is based, however, on a presentation of a large variety of historical, but also most recent activities in data warehousing, data retrieval and linking medical informatics with translational research. The article presents an overview of the various international approaches to this issue and illustrates concepts and solutions which have been published, thus giving an impression of activities pursued in this field of medical informatics. Further, problems and open questions, which have also been named in the literature, are presented and three challenges (to establish comprehensive clinical data warehouses, to establish professional IT infrastructure applications supporting clinical trial data capture and to integrate medical record systems and clinical trial databases) related to this area of medical informatics are identified and presented. Translational biomedical research with the aim "to integrate bedside and biology" and to bridge the gap between clinical care and medical research today and in the years to come, provides a large and interesting field for medical informatics researchers. Especially the need for integrating clinical research projects with data repositories built up during documentation of routine clinical care, today still leaves
Ückert, Frank; Ammenwerth, Elske; Dujat, Carl; Grant, Andrew; Haux, Reinhold; Hein, Andreas; Hochlehnert, Achim; Knaup-Gregori, Petra; Kulikowski, Casimir; Mantas, John; Maojo, Victor; Marschollek, Michael; Moura, Lincoln; Plischke, Maik; Röhrig, Rainer; Stausberg, Jürgen; Takabayashi, Katsuhiko; Winter, Alfred; Wolf, Klaus-Hendrik; Hasman, Arie
More than 10 years ago Haux et al. tried to answer the question how health care provision will look like in the year 2013. A follow-up workshop was held in Braunschweig, Germany, for 2 days in May, 2013, with 20 invited international experts in biomedical and health informatics. Among other things it had the objectives to discuss the suggested goals and measures of 2002 and how priorities on MI research in this context should be set from the viewpoint of today. The goals from 2002 are now as up-to-date as they were then. The experts stated that the three goals: "patient-centred recording and use of medical data for cooperative care"; "process-integrated decision support through current medical knowledge" and "comprehensive use of patient data for research and health care reporting" have not been reached yet and are still relevant. A new goal for ICT in health care should be the support of patient centred personalized (individual) medicine. MI as an academic discipline carries out research concerning tools that support health care professionals in their work. This research should be carried out without the pressure that it should lead to systems that are immediately and directly accepted in practice.
Full Text Available This paper investigates the ability of a group of Primary Care professionals to acquire appropriate document retrieval skills, so that they can apply evidence based health care techniques to their various Primary Care roles. The participants, most of whom had little prior experience of the Internet, were enrolled on a two-year part-time Postgraduate Diploma / MSc in Primary Care. As part of the course, they took a compulsory 12-week module in Medical Informatics. A specific task was set: to find appropriate information on Meningococcal Meningitis and Public Health, by using National Library of Medicine's PUBMED bibliographic retrieval system and other unspecified Internet sources. A supplementary piece of coursework required the group to become information providers by providing tutorials on the world wide web. Analysis of the reports showed that the participants were able to learn and use the information tools successfully and that appropriate skills can be transferred in a short time. Overall nine were positive as to the benefits of the evidence-based approach contributing to local health care, with nine expressing mixed views and two having more negative opinions.
Providing a high-quality service to patients involves having the right information at the ... Knowledge and practice and application of computer technology in both ... informatics and to stimulate interest in computer support in health care in our ...
In 2012, Health/Medical informatics profession celebrates five jubilees in Bosnia and Herzegovina: a) Thirty five years from the introduction of the first automatic manipulation of data; b) Twenty five years from establishing Society for Medical Informatics BiH; c) Twenty years from establishing scientific and professional journal of the Society for Medical Informatics of Bosnia and Herzegovina "Acta Informatica Medica"; d) Twenty years from establishing first Cathdra for Medical Informatics on biomedical faculties in Bosnia and Herzegovina and e) Ten years from the introduction of "Distance learning" in medical curriculum. All of the five mentioned activities in the area of Medical informatics had special importance and gave appropriate contribution in the development of Health/Medical informatics in Bosnia And Herzegovina.
Gonzalez Bernaldo de Quiros, F; Luna, D; Otero, P; Baum, A; Borbolla, D
Medical Informatics (MI) is an emerging discipline with a high need of trained and skillful professionals. To describe the educational experience of the Department of Health Informatics of the Hospital Italiano de Buenos Aires. A descriptive study of the development of the Medical Informatics Residency Program (MIRP) and the e-learning courses related to medical informatics. A four-year MIRP with 15 rotations was started in 2000, and was awarded national educational accreditation. Eight residents have been fully trained and their main academic contributions are shown in this study. The e-learning courses related to medical informatics (Healthcare Management, Epidemiology & Biostatistics, Information Retrieval, Computer Literacy started, 10x10 Spanish version and HL7 introductory course) started in 2006 and were followed by more than 2266 students from all over the world, with an increase trend in foreign students. These educational activities have produced skilled human resources for the development and maintenance of the health informatics projects at our Hospital. In parallel, the number of students trained by e-learning continues to increase, demonstrating the worldwide need of knowledge in this field.
Janamanchi, Balaji; Katsamakas, Evangelos; Raghupathi, Wullianallur; Gao, Wei
Little has been published about the application profiles and development patterns of open source software (OSS) in health and medical informatics. This study explores these issues with an analysis of health and medical informatics related OSS projects on SourceForge, a large repository of open source projects. A search was conducted on the SourceForge website during the period from May 1 to 15, 2007, to identify health and medical informatics OSS projects. This search resulted in a sample of 174 projects. A Java-based parser was written to extract data for several of the key variables of each project. Several visually descriptive statistics were generated to analyze the profiles of the OSS projects. Many of the projects have sponsors, implying a growing interest in OSS among organizations. Sponsorship, we discovered, has a significant impact on project success metrics. Nearly two-thirds of the projects have a restrictive license type. Restrictive licensing may indicate tighter control over the development process. Our sample includes a wide range of projects that are at various stages of development (status). Projects targeted towards the advanced end user are primarily focused on bio-informatics, data formats, database and medical science applications. We conclude that there exists an active and thriving OSS development community that is focusing on health and medical informatics. A wide range of OSS applications are in development, from bio-informatics to hospital information systems. A profile of OSS in health and medical informatics emerges that is distinct and unique to the health care field. Future research can focus on OSS acceptance and diffusion and impact on cost, efficiency and quality of health care.
Ückert, Frank; Ammenwerth, Elske; Dujat, Carl; Grant, Andrew; Haux, Reinhold; Hein, Andreas; Hochlehnert, Achim; Knaup-Gregori, Petra; Kulikowski, Casimir; Mantas, John; Maojo, Victor; Marschollek, Michael; Moura, Lincoln; Plischke, Maik; Röhrig, Rainer; Stausberg, Jürgen; Takabayashi, Katsuhiko; Winter, Alfred; Wolf, Klaus-Hendrik; Hasman, Arie
More than 10 years ago Haux et al. tried to answer the question how health care provision will look like in the year 2013. A follow-up workshop was held in Braunschweig, Germany, for 2 days in May, 2013, with 20 invited international experts in biomedical and health informatics. Among other things
Kiah, M L M; Zaidan, B B; Zaidan, A A; Nabi, Mohamed; Ibraheem, Rabiu
The advancement of information technology has facilitated the automation and feasibility of online information sharing. The second generation of the World Wide Web (Web 2.0) enables the collaboration and sharing of online information through Web-serving applications. Data mashup, which is considered a Web 2.0 platform, plays an important role in information and communication technology applications. However, few ideas have been transformed into education and research domains, particularly in medical informatics. The creation of a friendly environment for medical informatics research requires the removal of certain obstacles in terms of search time, resource credibility, and search result accuracy. This paper considers three glitches that researchers encounter in medical informatics research; these glitches include the quality of papers obtained from scientific search engines (particularly, Web of Science and Science Direct), the quality of articles from the indices of these search engines, and the customizability and flexibility of these search engines. A customizable search engine for trusted resources of medical informatics was developed and implemented through data mashup. Results show that the proposed search engine improves the usability of scientific search engines for medical informatics. Pipe search engine was found to be more efficient than other engines.
Luneski, Andrej; Bamidis, Panagiotis D; Hitoglou-Antoniadou, Madga
The area of affective computing has received significant attention by the research community over the last few years. In this paper we review the underlying principles in the field, in an effort to draw threads for possible future development within medical informatics. The approach is lead by considering the three main affective channels, namely, visual, audio/speech, and physiological in relation to e-health, emotional intelligence and e-learning. A discussion on the importance of past and present applications together with a prediction on future literature output is also provided.
Maojo, Victor; Kulikowski, Casimir A.
In this report, the authors compare and contrast medical informatics (MI) and bioinformatics (BI) and provide a viewpoint on their complementarities and potential for collaboration in various subfields. The authors compare MI and BI along several dimensions, including: (1) historical development of the disciplines, (2) their scientific foundations, (3) data quality and analysis, (4) integration of knowledge and databases, (5) informatics tools to support practice, (6) informatics methods to support research (signal processing, imaging and vision, and computational modeling, (7) professional and patient continuing education, and (8) education and training. It is pointed out that, while the two disciplines differ in their histories, scientific foundations, and methodologic approaches to research in various areas, they nevertheless share methods and tools, which provides a basis for exchange of experience in their different applications. MI expertise in developing health care applications and the strength of BI in biological “discovery science” complement each other well. The new field of biomedical informatics (BMI) holds great promise for developing informatics methods that will be crucial in the development of genomic medicine. The future of BMI will be influenced strongly by whether significant advances in clinical practice and biomedical research come about from separate efforts in MI and BI, or from emerging, hybrid informatics subdisciplines at their interface. PMID:12925552
Byrd, Gary D; Winkelstein, Peter
Based on the authors' shared interest in the interprofessional challenges surrounding health information management, this study explores the degree to which librarians, informatics professionals, and core health professionals in medicine, nursing, and public health share common ethical behavior norms grounded in moral principles. Using the "Principlism" framework from a widely cited textbook of biomedical ethics, the authors analyze the statements in the ethical codes for associations of librarians (Medical Library Association [MLA], American Library Association, and Special Libraries Association), informatics professionals (American Medical Informatics Association [AMIA] and American Health Information Management Association), and core health professionals (American Medical Association, American Nurses Association, and American Public Health Association). This analysis focuses on whether and how the statements in these eight codes specify core moral norms (Autonomy, Beneficence, Non-Maleficence, and Justice), core behavioral norms (Veracity, Privacy, Confidentiality, and Fidelity), and other norms that are empirically derived from the code statements. These eight ethical codes share a large number of common behavioral norms based most frequently on the principle of Beneficence, then on Autonomy and Justice, but rarely on Non-Maleficence. The MLA and AMIA codes share the largest number of common behavioral norms, and these two associations also share many norms with the other six associations. The shared core of behavioral norms among these professions, all grounded in core moral principles, point to many opportunities for building effective interprofessional communication and collaboration regarding the development, management, and use of health information resources and technologies.
... Organizations: Delisting for Cause for Medical Informatics AGENCY: Agency for Healthcare Research and Quality... Safety Organization (PSO) due to its failure to correct a deficiency. The Patient Safety and Quality... organizations whose mission and primary activity is to conduct activities to improve patient safety and the...
The article studies the development process of medical informatics specialty terminology as the ground for further research into foreign countries' experience, including the Canadian one, of specialists' professional training in the field of MI. The study determines the origin and chief stages of the formation and development of the medical…
Otto, Anthony; Kushniruk, Andre
It is generally accepted that Information Technology (IT) is a highly desirable and a very necessary ingredient of modern health care. Review of available literature reveals a paucity of medical informatics and information technology courses in undergraduate medical curricula and a lack of research to assess the effectiveness of medical informatics in undergraduate medical education. The need for such initiatives is discussed and a pilot project is described that evaluated the effectiveness of education in the use of Electronic Medical Record (EMR) applications. Educational activities, for example, could be medical students conducting virtual medical encounters or interacting with EMR applications. An EMR application, which was used in several related projects, has been adapted to the educational environment: standardized patient records can be created and cloned so that individual students can interact with a "standard" patient and alter the patient's data.
Li, Man; Pickering, Brian W.; Smith, Vernon D.; Hadzikadic, Mirsad; Gajic, Ognjen; Herasevich, Vitaly
Medical Informatics has become an important tool in modern health care practice and research. In the present article we outline the challenges and opportunities associated with the implementation of electronic medical records (EMR) in complex environments such as intensive care units (ICU). We share our initial experience in the design, maintenance and application of a customized critical care, Microsoft SQL based, research warehouse, ICU DataMart. ICU DataMart integrates clinical and adminis...
Man Li; Brian W. Pickering; Vernon D. Smith; Mirsad Hadzikadic; Ognjen Gajic; Vitaly Herasevich
Medical Informatics has become an important tool in modern health care practice and research. In the present article we outline the challenges and opportunities associated with the implementation of electronic medical records (EMR) in complex environments such as intensive care units (ICU). We share our initial experience in the design, maintenance and application of a customized critical care, Microsoft SQL based, research warehouse, ICU DataMart. ICU DataMart integrates clinical and adminis...
Clinical Informatics Consult Service Positively Affects Some Clinical Decisions in the ICU. A Review of: Mulvaney, Shelagh A., Leonard Bickman, Nunzia B. Giuse, Warren E. Lambert, Nila A. Sathe, and Rebecca N. Jerome." A Randomized Effectiveness Trial of a Clinical Informatics Consult Service: Impact on Evidence-based Decision-making and Knowledge Implementation." Journal of the American Medical Informatics Association 15.2 (2008: 203-11.
Full Text Available Objective – To determine whether the provision of synthesized research evidence provided by the Clinical Informatics Consult Service (CICS affects the clinical decision-making of clinicians working in intensive care units (ICUs.Design – Non-blinded randomized control effectiveness trial.Setting – ICUs in United States-based 658 bed university hospital providing tertiary care for adults and children.Subjects – Clinical staff working within one of four ICUs who submitted a request for clinical information during the study period.Methods – Valid requests submitted by clinical staff from the four clinical ICUs (medical, paediatric, trauma, or neonatal were randomly allocated to receive information from the CICS (CICS provided or no information (no CICS provided. Pre-consult forms, completed at the time of the request, examined reasons for the request and the clinical actions clinicians thought might be influenced by the search results. Requestors could opt out of the no CICS provided group either before or after the randomization of their request. Responses to requests, supplied within 0.5 to 7 days as agreed with the requestor, included a search strategy and bibliographic references, a targeted list of full-text articles, and a written synthesis and critique of the relevant research. Clinicians within both groups were free to conduct their own searches and reviews. An online evaluation form, emailed to recipients, was used to assess the impact of the information supplied. The evaluation form asked clinicians to record the time spent on their own searches, sources of information consulted including colleagues, the immediate and future impact of the information provided (either from the CICS or their own searches, what influence the information had on their clinical actions, whether there were any barriers to using the information, and quality and overall satisfaction with the results provided by the CICS. Data was analyzed according to the
Medical school professors and lecturers are often called to be practicing clinicians, researchers in their own field, in addition to executing their education and curricular responsibilities. Some further accumulate healthcare management responsibilities. These areas pose conflicting demands on time and intellectual activity, but despite their apparent differences, knowledge and skills from management, leadership and informatics may prove useful in helping to smooth these conflicts and hence increase personal effectiveness in these areas. This article tries to clarify some concepts and advance why training in management, leadership and health informatics would seem particularly useful for the medical academic. As opposed to the idea of educational dispersion/specialization, the concept of an integrative tetrahedronal education framework is advanced as a way to plan workshops and other faculty development activities which could be implemented transnationally as well as locally.
... the Payment Process Physician Payment Resource Center Reinventing Medical Practice Managing Your Practice CPT® (Current Procedural Terminology) Medicare & Medicaid Private Payer Reform Claims Processing & Practice ...
Peer-reviewed journals remain important vehicles for knowledge transfer and dissemination in health informatics, yet, their format, processes and business models are changing only slowly. Up to the end of last century, it was common for individual researchers and scientific organizations to leave the business of knowledge transfer to professional publishers, signing away their rights to the works in the process, which in turn impeded wider dissemination. Traditional medical informatics journals are poorly cited and the visibility and uptake of articles beyond the medical informatics community remain limited. In 1999, the Journal of Medical Internet Research (JMIR; http://www.jmir.org) was launched, featuring several innovations including 1) ownership and copyright retained by the authors, 2) electronic-only, "lean" non-for-profit publishing, 3) openly accessible articles with a reversed business model (author pays instead of reader pays), 4) technological innovations such as automatic XML tagging and reference checking, on-the-fly PDF generation from XML, etc., enabling wide distribution in various bibliographic and full-text databases. In the past 10 years, despite limited resources, the journal has emerged as a leading journal in health informatics, and is presently ranked the top journal in the medical informatics and health services research categories by impact factor. The paper summarizes some of the features of the Journal, and uses bibliometric and access data to compare the influence of the Journal on the discipline of medical informatics and other disciplines. While traditional medical informatics journals are primarily cited by other Medical Informatics journals (33%-46% of citations), JMIR papers are to a more often cited by "end-users" (policy, public health, clinical journals), which may be partly attributable to the "open access advantage".
Full Text Available William R Hersh,1 Paul N Gorman,1 Frances E Biagioli,2 Vishnu Mohan,1 Jeffrey A Gold,3 George C Mejicano4 1Department of Medical Informatics and Clinical Epidemiology, 2Department of Family Medicine, 3Department of Medicine, 4School of Medicine, Oregon Health & Science University, Portland, OR, USA Abstract: Physicians in the 21st century will increasingly interact in diverse ways with information systems, requiring competence in many aspects of clinical informatics. In recent years, many medical school curricula have added content in information retrieval (search and basic use of the electronic health record. However, this omits the growing number of other ways that physicians are interacting with information that includes activities such as clinical decision support, quality measurement and improvement, personal health records, telemedicine, and personalized medicine. We describe a process whereby six faculty members representing different perspectives came together to define competencies in clinical informatics for a curriculum transformation process occurring at Oregon Health & Science University. From the broad competencies, we also developed specific learning objectives and milestones, an implementation schedule, and mapping to general competency domains. We present our work to encourage debate and refinement as well as facilitate evaluation in this area. Keywords: curriculum transformation, clinical decision support, patient safety, health care quality, patient engagement
Liang, Jun; Wei, Kunyan; Meng, Qun; Chen, Zhenying; Zhang, Jiajie; Lei, Jianbo
China launched its second health reform in 2010 with considerable investments in medical informatics (MI). However, to the best of our knowledge, research on the outcomes of this ambitious undertaking has been limited. Our aim was to understand the development of MI and the state of continuing education in China and the United States from the perspective of conferences. We conducted a quantitative and qualitative analysis of four MI conferences in China and two in the United States: China Medical Information Association Annual Symposium (CMIAAS), China Hospital Information Network Annual Conference (CHINC), China Health Information Technology Exchange Annual Conference (CHITEC), China Annual Proceeding of Medical Informatics (CPMI) versus the American Medical Informatics Association (AMIA) and Healthcare Information and Management Systems Society (HIMSS). The scale, composition, and regional distribution of attendees, topics, and research fields for each conference were summarized and compared. CMIAAS and CPMI are mainstream academic conferences, while CHINC and CHITEC are industry conferences in China. Compared to HIMSS 2016, the meeting duration of CHITEC was 3 versus 5 days, the number of conference sessions was 132 versus 950+, the number of attendees was 5000 versus 40,000+, the number of vendors was 152 versus 1400+, the number of subforums was 12 versus 230, the number of preconference education symposiums and workshops was 0 versus 12, and the duration of preconference educational symposiums and workshops was 0 versus 1 day. Compared to AMIA, the meeting duration of Chinese CMIAAS was 2 versus 5 days, the number of conference sessions was 42 versus 110, the number of attendees was 200 versus 2500+, the number of vendors was 5 versus 75+, and the number of subforums was 4 versus 10. The number of preconference tutorials and working groups was 0 versus 29, and the duration of tutorials and working group was 0 versus 1.5 days. Given the size of the Chinese
Li, Man; Pickering, Brian W; Smith, Vernon D; Hadzikadic, Mirsad; Gajic, Ognjen; Herasevich, Vitaly
Medical Informatics has become an important tool in modern health care practice and research. In the present article we outline the challenges and opportunities associated with the implementation of electronic medical records (EMR) in complex environments such as intensive care units (ICU). We share our initial experience in the design, maintenance and application of a customized critical care, Microsoft SQL based, research warehouse, ICU DataMart. ICU DataMart integrates clinical and administrative data from heterogeneous sources within the EMR to support research and practice improvement in the ICUs. Examples of intelligent alarms -- "sniffers", administrative reports, decision support and clinical research applications are presented.
Full Text Available Medical Informatics has become an important tool in modern health care practice and research. In the present article we outline the challenges and opportunities associated with the implementation of electronic medical records (EMR in complex environments such as intensive care units (ICU. We share our initial experience in the design, maintenance and application of a customized critical care, Microsoft SQL based, research warehouse, ICU DataMart. ICU DataMart integrates clinical and administrative data from heterogeneous sources within the EMR to support research and practice improvement in the ICUs. Examples of intelligent alarms – “sniffers”, administrative reports, decision support and clinical research applications are presented.
Haux, Reinhold; Kulikowski, Casimir A; Bakken, Suzanne; de Lusignan, Simon; Kimura, Michio; Koch, Sabine; Mantas, John; Maojo, Victor; Marschollek, Michael; Martin-Sanchez, Fernando; Moen, Anne; Park, Hyeoun-Ae; Sarkar, Indra N; Leong, Tze Yun; McCray, Alexa T
Medical informatics, or biomedical and health informatics (BMHI), has become an established scientific discipline. In all such disciplines there is a certain inertia to persist in focusing on well-established research areas and to hold on to well-known research methodologies rather than adopting new ones, which may be more appropriate. To search for answers to the following questions: What are research fields in informatics, which are not being currently adequately addressed, and which methodological approaches might be insufficiently used? Do we know about reasons? What could be consequences of change for research and for education? Outstanding informatics scientists were invited to three panel sessions on this topic in leading international conferences (MIE 2015, Medinfo 2015, HEC 2016) in order to get their answers to these questions. A variety of themes emerged in the set of answers provided by the panellists. Some panellists took the theoretical foundations of the field for granted, while several questioned whether the field was actually grounded in a strong theoretical foundation. Panellists proposed a range of suggestions for new or improved approaches, methodologies, and techniques to enhance the BMHI research agenda. The field of BMHI is on the one hand maturing as an academic community and intellectual endeavour. On the other hand vendor-supplied solutions may be too readily and uncritically accepted in health care practice. There is a high chance that BMHI will continue to flourish as an important discipline; its innovative interventions might then reach the original objectives of advancing science and improving health care outcomes.
Vaitsis, Christos; Nilsson, Gunnar; Zary, Nabil
A continuous effort to improve healthcare education today is currently driven from the need to create competent health professionals able to meet healthcare demands. Limited research reporting how educational data manipulation can help in healthcare education improvement. The emerging research field of visual analytics has the advantage to combine big data analysis and manipulation techniques, information and knowledge representation, and human cognitive strength to perceive and recognise visual patterns. The aim of this study was therefore to explore novel ways of representing curriculum and educational data using visual analytics. Three approaches of visualization and representation of educational data were presented. Five competencies at undergraduate medical program level addressed in courses were identified to inaccurately correspond to higher education board competencies. Different visual representations seem to have a potential in impacting on the ability to perceive entities and connections in the curriculum data.
Zakaria, Nasriah; Jamal, Amr; Bisht, Shekhar; Koppel, Cristina
Public universities in Saudi Arabia today are making substantial investments in e-learning as part of their educational system, especially in the implementation of learning management systems (LMS). To our knowledge, this is the first study conducted in Saudi Arabia exploring medical students' experience with an LMS, particularly as part of a medical informatics course. This study investigates students' use of various features of the LMS embedded in a recently implemented medical informatics course. A mixed methodology approach was employed. Survey questionnaires were distributed to all third year medical informatics students at the end of the course. In addition, two focus group sessions were conducted with twelve students. A thematic analysis of the focus group was performed. A total of 265 third year medical student surveys (167/265, 63% male and 98/265, 37% female) were completed and analyzed. Overall, 50.6% (134/265) of the students agreed that the course was well planned and up-to-date, had clearly stated objectives and clear evaluation methods, appropriate course assignment, and that the LMS offered easy navigation. Most of the students rated the course as good/fair overall. In general, females were 10.4% more likely to prefer the LMS, as revealed by higher odd ratios (odds ratio [OR] 1.104, 95% CI 0.86-1.42) compared to males. Survey results showed that students' use of LMS tools increased after taking the course compared to before taking the course. The full model containing all items were statistically significant (χ(2) 25=69.52, Pstudents who had positive attitudes towards LMS and those who did not. The focus group, however, revealed that the students used social networking for general use rather than learning purposes, but they were using other Internet resources and mobile devices for learning. Male students showed a higher preference for using technology in general to enhance learning activities. Overall, medical student attitudes towards the LMS
Petrovecki, Mladen; Rahelić, Dario; Bilić-Zulle, Lidija; Jelec, Vjekoslav
To investigate whether and to what extent various parameters, such as individual characteristics, computer habits, situational factors, and pseudoscientific variables, influence Medical Informatics examination grade, and how inadequate statistical analysis can lead to wrong conclusions. The study included a total of 382 second-year undergraduate students at the Rijeka University School of Medicine in the period from 1996/97 to 2000/01 academic year. After passing the Medical Informatics exam, students filled out an anonymous questionnaire about their attitude toward learning medical informatics. They were asked to grade the course organization and curriculum content, and provide their date of birth; sex; study year; high school grades; Medical Informatics examination grade, type, and term; and describe their computer habits. From these data, we determined their zodiac signs and biorhythm. Data were compared by the use of t-test, one-way ANOVA with Tukey's honest significance difference test, and randomized complete block design ANOVA. Out of 21 variables analyzed, only 10 correlated with the average grade. Students taking Medical Informatics examination in the 1998/99 academic year earned lower average grade than any other generation. Significantly higher Medical Informatics exam grade was earned by students who finished a grammar high school; owned and regularly used a computer, Internet, and e-mail (pzodiac sign, zodiac sign quality, or biorhythm cycles, except when intentionally inadequate statistics was used for data analysis. Medical Informatics examination grades correlated with general learning capacity and computer habits of students, but showed no relation to other investigated parameters, such as examination term or pseudoscientific parameters. Inadequate statistical analysis can always confirm false conclusions.
de la Calle, Guillermo; García-Remesal, Miguel; Nkumu-Mbomio, Nelida; Kulikowski, Casimir; Maojo, Victor
Over the past years, the number of available informatics resources in medicine has grown exponentially. While specific inventories of such resources have already begun to be developed for Bioinformatics (BI), comparable inventories are as yet not available for the Medical Informatics (MI) field, so that locating and accessing them currently remains a difficult and time-consuming task. We have created a repository of MI resources from the scientific literature, providing free access to its contents through a web-based service. We define informatics resources as all those elements that constitute, serve to define or are used by informatics systems, ranging from architectures or development methodologies to terminologies, vocabularies, databases or tools. Relevant information describing the resources is automatically extracted from manuscripts published in top-ranked MI journals. We used a pattern matching approach to detect the resources' names and their main features. Detected resources are classified according to three different criteria: functionality, resource type and domain. To facilitate these tasks, we have built three different classification schemas by following a novel approach based on folksonomies and social tagging. We adopted the terminology most frequently used by MI researchers in their publications to create the concepts and hierarchical relationships belonging to the classification schemas. The classification algorithm identifies the categories associated with resources and annotates them accordingly. The database is then populated with this data after manual curation and validation. We have created an online repository of MI resources to assist researchers in locating and accessing the most suitable resources to perform specific tasks. The database contains 609 resources at the time of writing and is available at http://www.gib.fi.upm.es/eMIR2. We are continuing to expand the number of available resources by taking into account further
de la Calle Guillermo
Full Text Available Abstract Background Over the past years, the number of available informatics resources in medicine has grown exponentially. While specific inventories of such resources have already begun to be developed for Bioinformatics (BI, comparable inventories are as yet not available for the Medical Informatics (MI field, so that locating and accessing them currently remains a difficult and time-consuming task. Description We have created a repository of MI resources from the scientific literature, providing free access to its contents through a web-based service. We define informatics resources as all those elements that constitute, serve to define or are used by informatics systems, ranging from architectures or development methodologies to terminologies, vocabularies, databases or tools. Relevant information describing the resources is automatically extracted from manuscripts published in top-ranked MI journals. We used a pattern matching approach to detect the resources’ names and their main features. Detected resources are classified according to three different criteria: functionality, resource type and domain. To facilitate these tasks, we have built three different classification schemas by following a novel approach based on folksonomies and social tagging. We adopted the terminology most frequently used by MI researchers in their publications to create the concepts and hierarchical relationships belonging to the classification schemas. The classification algorithm identifies the categories associated with resources and annotates them accordingly. The database is then populated with this data after manual curation and validation. Conclusions We have created an online repository of MI resources to assist researchers in locating and accessing the most suitable resources to perform specific tasks. The database contains 609 resources at the time of writing and is available at http://www.gib.fi.upm.es/eMIR2. We are continuing to expand the number
Luneski, A; Konstantinidis, E; Bamidis, P D
Affective computing (AC) is concerned with emotional interactions performed with and through computers. It is defined as "computing that relates to, arises from, or deliberately influences emotions". AC enables investigation and understanding of the relation between human emotions and health as well as application of assistive and useful technologies in the medical domain. 1) To review the general state of the art in AC and its applications in medicine, and 2) to establish synergies between the research communities of AC and medical informatics. Aspects related to the human affective state as a determinant of the human health are discussed, coupled with an illustration of significant AC research and related literature output. Moreover, affective communication channels are described and their range of application fields is explored through illustrative examples. The presented conferences, European research projects and research publications illustrate the recent increase of interest in the AC area by the medical community. Tele-home healthcare, AmI, ubiquitous monitoring, e-learning and virtual communities with emotionally expressive characters for elderly or impaired people are few areas where the potential of AC has been realized and applications have emerged. A number of gaps can potentially be overcome through the synergy of AC and medical informatics. The application of AC technologies parallels the advancement of the existing state of the art and the introduction of new methods. The amount of work and projects reviewed in this paper witness an ambitious and optimistic synergetic future of the affective medicine field.
Lapão, Luís Velez
The digital revolution is gradually transforming our society. What about the effects of digitalization and Internet of Things in healthcare? Among researchers two ideas are dominating, opposing each other. These arguments will be explored and analyzed. A mix-method approach combining literature review with the results from a focus group on eHealth impact on employment is used. Several experts from the WHO and from Health Professional Associations contributed for this analysis. Depending on the type of service it will entail reductions or more need of healthcare workers, yet whatever the scenario medical informatics will play an increasing role.
Hilty, Donald M; Hales, Deborah J; Briscoe, Greg; Benjamin, Sheldon; Boland, Robert J; Luo, John S; Chan, Carlyle H; Kennedy, Robert S; Karlinsky, Harry; Gordon, Daniel B; Yager, Joel; Yellowlees, Peter M
This article provides a brief overview of important issues for educators regarding medical education and technology. The literature describes key concepts, prototypical technology tools, and model programs. A work group of psychiatric educators was convened three times by phone conference to discuss the literature. Findings were presented to and input was received from the 2005 Summit on Medical Student Education by APA and the American Directors of Medical Student Education in Psychiatry. Knowledge of, skills in, and attitudes toward medical informatics are important to life-long learning and modern medical practice. A needs assessment is a starting place, since student, faculty, institution, and societal factors bear consideration. Technology needs to "fit" into a curriculum in order to facilitate learning and teaching. Learning about computers and applying computer technology to education and clinical care are key steps in computer literacy for physicians.
Russell, Marie; Brittain, J. Michael
Identifies current trends and issues in health informatics with examples of applications, particularly in English-speaking countries. Topics include health systems, professionals, and patients; consumer health information; electronic medical records; nursing; privacy and confidentiality; finding and using information; the Internet; e-mail;…
Background Public universities in Saudi Arabia today are making substantial investments in e-learning as part of their educational system, especially in the implementation of learning management systems (LMS). To our knowledge, this is the first study conducted in Saudi Arabia exploring medical students’ experience with an LMS, particularly as part of a medical informatics course. Objective This study investigates students’ use of various features of the LMS embedded in a recently implemented medical informatics course. Methods A mixed methodology approach was employed. Survey questionnaires were distributed to all third year medical informatics students at the end of the course. In addition, two focus group sessions were conducted with twelve students. A thematic analysis of the focus group was performed. Results A total of 265 third year medical student surveys (167/265, 63% male and 98/265, 37% female) were completed and analyzed. Overall, 50.6% (134/265) of the students agreed that the course was well planned and up-to-date, had clearly stated objectives and clear evaluation methods, appropriate course assignment, and that the LMS offered easy navigation. Most of the students rated the course as good/fair overall. In general, females were 10.4% more likely to prefer the LMS, as revealed by higher odd ratios (odds ratio [OR] 1.104, 95% CI 0.86-1.42) compared to males. Survey results showed that students’ use of LMS tools increased after taking the course compared to before taking the course. The full model containing all items were statistically significant (χ2 25=69.52, Pstudents who had positive attitudes towards LMS and those who did not. The focus group, however, revealed that the students used social networking for general use rather than learning purposes, but they were using other Internet resources and mobile devices for learning. Male students showed a higher preference for using technology in general to enhance learning activities. Overall
Pickens, D; Flynn, M; Peck, D
Medical Physics 2.0 is a bold vision for an existential transition of clinical imaging physics in face of the new realities of value-based and evidence-based medicine, comparative effectiveness, and meaningful use. It speaks to how clinical imaging physics can expand beyond traditional insular models of inspection and acceptance testing, oriented toward compliance, towards team-based models of operational engagement, prospective definition and assurance of effective use, and retrospective evaluation of clinical performance. Organized into four sessions of the AAPM, this particular session focuses on three specific modalities as outlined below. MRI 2.0: This presentation will look into the future of clinical MR imaging and what the clinical medical physicist will need to be doing as the technology of MR imaging evolves. Many of the measurement techniques used today will need to be expanded to address the advent of higher field imaging systems and dedicated imagers for specialty applications. Included will be the need to address quality assurance and testing metrics for multi-channel MR imagers and hybrid devices such as MR/PET systems. New pulse sequences and acquisition methods, increasing use of MR spectroscopy, and real-time guidance procedures will place the burden on the medical physicist to define and use new tools to properly evaluate these systems, but the clinical applications must be understood so that these tools are use correctly. Finally, new rules, clinical requirements, and regulations will mean that the medical physicist must actively work to keep her/his sites compliant and must work closely with physicians to ensure best performance of these systems. Informatics Display 1.0 to 2.0: Medical displays are an integral part of medical imaging operation. The DICOM and AAPM (TG18) efforts have led to clear definitions of performance requirements of monochrome medical displays that can be followed by medical physicists to ensure proper performance. However
Pickens, D [Vanderbilt Medical Center, Nashville, TN (United States); Flynn, M; Peck, D [Henry Ford Health System, Detroit, MI (United States)
Medical Physics 2.0 is a bold vision for an existential transition of clinical imaging physics in face of the new realities of value-based and evidence-based medicine, comparative effectiveness, and meaningful use. It speaks to how clinical imaging physics can expand beyond traditional insular models of inspection and acceptance testing, oriented toward compliance, towards team-based models of operational engagement, prospective definition and assurance of effective use, and retrospective evaluation of clinical performance. Organized into four sessions of the AAPM, this particular session focuses on three specific modalities as outlined below. MRI 2.0: This presentation will look into the future of clinical MR imaging and what the clinical medical physicist will need to be doing as the technology of MR imaging evolves. Many of the measurement techniques used today will need to be expanded to address the advent of higher field imaging systems and dedicated imagers for specialty applications. Included will be the need to address quality assurance and testing metrics for multi-channel MR imagers and hybrid devices such as MR/PET systems. New pulse sequences and acquisition methods, increasing use of MR spectroscopy, and real-time guidance procedures will place the burden on the medical physicist to define and use new tools to properly evaluate these systems, but the clinical applications must be understood so that these tools are use correctly. Finally, new rules, clinical requirements, and regulations will mean that the medical physicist must actively work to keep her/his sites compliant and must work closely with physicians to ensure best performance of these systems. Informatics Display 1.0 to 2.0: Medical displays are an integral part of medical imaging operation. The DICOM and AAPM (TG18) efforts have led to clear definitions of performance requirements of monochrome medical displays that can be followed by medical physicists to ensure proper performance. However
RESTful web services nowadays are state-of-the-art in business transactions over the internet. They are however not very much used in medical informatics and in clinical research, especially not in Europe. To make an inventory of RESTful web services that can be used in medical informatics and clinical research, including those that can help in patient empowerment in the DACH region and in Europe, and to develop some new RESTful web services for use in clinical research and regulatory review. A literature search on available RESTful web services has been performed and new RESTful web services have been developed on an application server using the Java language. Most of the web services found originate from institutes and organizations in the USA, whereas no similar web services could be found that are made available by European organizations. New RESTful web services have been developed for LOINC codes lookup, for UCUM conversions and for use with CDISC Standards. A comparison is made between "top down" and "bottom up" web services, the latter meant to answer concrete questions immediately. The lack of RESTful web services made available by European organizations in healthcare and medical informatics is striking. RESTful web services may in short future play a major role in medical informatics, and when localized for the German language and other European languages, can help to considerably facilitate patient empowerment. This however requires an EU equivalent of the US National Library of Medicine.
Behrends, Marianne; Steffens, Sandra; Marschollek, Michael
The National Competence Based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM) describes medical skills and attitudes without being ordered by subjects or organs. Thus, the NKLM enables systematic curriculum mapping and supports curricular transparency. In this paper we describe where learning objectives related to Medical Informatics (MI) in Hannover coincide with other subjects and where they are taught exclusively in MI. An instance of the web-based MERLIN-database was used for the mapping process. In total 52 learning objectives overlapping with 38 other subjects could be allocated to MI. No overlap exists for six learning objectives describing explicitly topics of information technology or data management for scientific research. Most of the overlap was found for learning objectives relating to documentation and aspects of data privacy. The identification of numerous shared learning objectives with other subjects does not mean that other subjects teach the same content as MI. Identifying common learning objectives rather opens up the possibility for teaching cooperations which could lead to an important exchange and hopefully an improvement in medical education. Mapping of a whole medical curriculum offers the opportunity to identify common ground between MI and other medical subjects. Furthermore, in regard to MI, the interaction with other medical subjects can strengthen its role in medical education.
Biomedical or clinical informatics is the transdisciplinary field that studies and develops effective uses of biomedical data, information technology innovations, and medical knowledge for scientific inquiry, problem solving, and decision making, with an emphasis on improving human health. Given the ongoing advances in information technology, the field of informatics is becoming important to clinical practice and to residency education. This article will discuss how informatics is specifically relevant to residency education and the different ways to incorporate informatics into residency education, and will highlight applications of current technology in the context of residency education. How informatics can optimize communication for residents, promote information technology use, refine documentation techniques, reduce medical errors, and improve clinical decision making will be reviewed. It is hoped that this article will increase faculty and trainees' knowledge of the field of informatics, awareness of available technology, and will assist practitioners to maximize their ability to provide quality care to their patients. This article will also introduce the idea of incorporating informatics specialists into residency programs to help practitioners deliver more evidenced-based care and to further improve their efficiency. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
Curioso, Walter H; Hansen, Jacquelyn R; Centurion-Lara, Arturo; Garcia, Patricia J; Wolf, Fredric M; Fuller, Sherrilynne; Holmes, King K; Kimball, Ann Marie
New technologies that emerge at the interface of computational and biomedical science could drive new advances in global health, therefore more training in technology is needed among health care workers. To assess the potential for informatics training using an approach designed to foster interaction at this interface, the University of Washington and the Universidad Peruana Cayetano Heredia developed and assessed a one-week course that included a new Bioinformatics (BIO) track along with an established Medical/Public Health Informatics track (MI) for participants in Peru. We assessed the background of the participants, and measured the knowledge gained by track-specific (MI or BIO) 30-minute pre- and post-tests. Participants' attitudes were evaluated both by daily evaluations and by an end-course evaluation. Forty-three participants enrolled in the course - 20 in the MI track and 23 in the BIO track. Of 20 questions, the mean % score for the MI track increased from 49.7 pre-test (standard deviation or SD = 17.0) to 59.7 (SD = 15.2) for the post-test (P = 0.002, n = 18). The BIO track mean score increased from 33.6 pre-test to 51.2 post-test (P < 0.001, n = 21). Most comments (76%) about any aspect of the course were positive. The main perceived strength of the course was the quality of the speakers, and the main perceived weakness was the short duration of the course. Overall, the course acceptability was very good to excellent with a rating of 4.1 (scale 1-5), and the usefulness of the course was rated as very good. Most participants (62.9%) expressed a positive opinion about having had the BIO and MI tracks come together for some of the lectures. Pre- and post-test results and the positive evaluations by the participants indicate that this first joint Bioinformatics and Medical/Public Health Informatics (MI and BIO) course was a success.
Geissbühler, A; Lovis, C; Spahni, S; Appel, R D; Ratib, O; Boyer, C; Hochstrasser, D F; Baud, R
To report about the work of Prof. Jean-Raoul Scherrer, and show how his humanist vision, his medical skills and his scientific background have enabled and shaped the development of medical informatics over the last 30 years. Starting with the mainframe-based patient-centered hospital information system DIOGENE in the 70s, Prof. Scherrer developed, implemented and evolved innovative concepts of man-machine interfaces, distributed and federated environments, leading the way with information systems that obstinately focused on the support of care providers and patients. Through a rigorous design of terminologies and ontologies, the DIOGENE data would then serve as a basis for the development of clinical research, data mining, and lead to innovative natural language processing techniques. In parallel, Prof. Scherrer supported the development of medical image management, ranging from a distributed picture archiving and communication systems (PACS) to molecular imaging of protein electrophoreses. Recognizing the need for improving the quality and trustworthiness of medical information on the Web, Prof. Scherrer created the Health-On-the-Net (HON) foundation. These achievements, made possible thanks to his visionary mind, deep humanism, creativity, generosity and determination, have made of Prof. Scherrer a true pioneer and leader of the human-centered, patient-oriented application of information technology for improving healthcare.
Bott, O J; Ammenwerth, E; Brigl, B; Knaup, P; Lang, E; Pilgram, R; Pfeifer, B; Ruderich, F; Wolff, A C; Haux, R; Kulikowski, C
To review recent research efforts in the field of ubiquitous computing in health care. To identify current research trends and further challenges for medical informatics. Analysis of the contents of the Yearbook on Medical Informatics 2005 of the International Medical Informatics Association (IMIA). The Yearbook of Medical Informatics 2005 includes 34 original papers selected from 22 peer-reviewed scientific journals related to several distinct research areas: health and clinical management, patient records, health information systems, medical signal processing and biomedical imaging, decision support, knowledge representation and management, education and consumer informatics as well as bioinformatics. A special section on ubiquitous health care systems is devoted to recent developments in the application of ubiquitous computing in health care. Besides additional synoptical reviews of each of the sections the Yearbook includes invited reviews concerning E-Health strategies, primary care informatics and wearable healthcare. Several publications demonstrate the potential of ubiquitous computing to enhance effectiveness of health services delivery and organization. But ubiquitous computing is also a societal challenge, caused by the surrounding but unobtrusive character of this technology. Contributions from nearly all of the established sub-disciplines of medical informatics are demanded to turn the visions of this promising new research field into reality.
Drozda, Joseph P; Roach, James; Forsyth, Thomas; Helmering, Paul; Dummitt, Benjamin; Tcheng, James E
The US Food and Drug Administration (FDA) has recognized the need to improve the tracking of medical device safety and performance, with implementation of Unique Device Identifiers (UDIs) in electronic health information as a key strategy. The FDA funded a demonstration by Mercy Health wherein prototype UDIs were incorporated into its electronic information systems. This report describes the demonstration's informatics architecture. Prototype UDIs for coronary stents were created and implemented across a series of information systems, resulting in UDI-associated data flow from manufacture through point of use to long-term follow-up, with barcode scanning linking clinical data with UDI-associated device attributes. A reference database containing device attributes and the UDI Research and Surveillance Database (UDIR) containing the linked clinical and device information were created, enabling longitudinal assessment of device performance. The demonstration included many stakeholders: multiple Mercy departments, manufacturers, health system partners, the FDA, professional societies, the National Cardiovascular Data Registry, and information system vendors. The resulting system of systems is described in detail, including entities, functions, linkage between the UDIR and proprietary systems using UDIs as the index key, data flow, roles and responsibilities of actors, and the UDIR data model. The demonstration provided proof of concept that UDIs can be incorporated into provider and enterprise electronic information systems and used as the index key to combine device and clinical data in a database useful for device evaluation. Keys to success and challenges to achieving this goal were identified. Fundamental informatics principles were central to accomplishing the system of systems model. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: firstname.lastname@example.org
Cummins, M. R.; Gundlapalli, A. V.; Murray, P.; Park, H.-A.; Lehmann, C. U.
Summary Introduction Official recognition and certification for informatics professionals are essential aspects of workforce development. Objective: To describe the history, pathways, and nuances of certification in nursing informatics across the globe; compare and contrast those with board certification in clinical informatics for physicians. Methods (1) A review of the representative literature on informatics certification and related competencies for nurses and physicians, and relevant websites for nursing informatics associations and societies worldwide; (2) similarities and differences between certification processes for nurses and physicians, and (3) perspectives on roles for nursing informatics professionals in healthcare Results The literature search for ‘nursing informatics certification’ yielded few results in PubMed; Google Scholar yielded a large number of citations that extended to magazines and other non-peer reviewed sources. Worldwide, there are several nursing informatics associations, societies, and workgroups dedicated to nursing informatics associated with medical/health informatics societies. A formal certification program for nursing informatics appears to be available only in the United States. This certification was established in 1992, in concert with the formation and definition of nursing informatics as a specialty practice of nursing by the American Nurses Association. Although informatics is inherently interprofessional, certification pathways for nurses and physicians have developed separately, following long-standing professional structures, training, and pathways aligned with clinical licensure and direct patient care. There is substantial similarity with regard to the skills and competencies required for nurses and physicians to obtain informatics certification in their respective fields. Nurses may apply for and complete a certification examination if they have experience in the field, regardless of formal training. Increasing
Patel, V L; Kaufman, D R; Allen, V G; Shortliffe, E H; Cimino, J J; Greenes, R A
The development and implementation of enabling tools and methods that provide ready access to knowledge and information are among the central goals of medical informatics. The need for multi-institutional collaboration in the development of such tools and methods is increasingly being recognized. Collaboration involves communication, which typically involves individuals who work together at the same location. With the evolution of electronic modalities for communication, we seek to understand the role that such technologies can play in supporting collaboration, especially when the participants are geographically separated. Using the InterMed Collaboratory as a subject of study, we have analyzed their activities as an exercise in computer- and network-mediated collaborative design. We report on the cognitive, sociocultural, and logistical issues encountered when scientists from diverse organizations and backgrounds use communications technologies while designing and implementing shared products. Results demonstrate that it is important to match carefully the content with the mode of communication, identifying, for example, suitable uses of E-mail, conference calls, and face-to-face meetings. The special role of leaders in guiding and facilitating the group activities can also be seen, regardless of the communication setting in which the interactions occur. Most important is the proper use of technology to support the evolution of a shared vision of group goals and methods, an element that is clearly necessary before successful collaborative designs can proceed.
Full Text Available The 13 th World Congress on Medical and Health Informatics (Medinfo was held in 2010 between 12 and 15 September in Cape Town, South Africa. This triennial international gathering is the official conference of the International Medical Informatics Association (IMIA and brings together leading health informatics leaders, scientists, clinicians, researchers, vendors, developers and government and health care planners from around the globe. The conference attracted 905 submissions and resulted in a program that included 260 oral presentations, 349 posters presentations and 21 scientific demonstrations representing contributions from 58 countries. The Medinfo program covered all aspects of health informatics from traditional areas, such as hospital information systems, patient registries, nursing informatics, data integration, standards, interoperability issues and decision support, to innovative topics, such as translational bioinformatics, text mining, intelligent data analysis, emerging technologies, quality, social networking, workflow and organizational issues. The outgoing President of the IMIA, Professor Reinhold Haux, presented on health informatics challenges into the future, reinforcing that today and in the future, health care has to be considered as part of a continuous and coordinated life-time journey and not just as episodes of disease. Medical informatics has a key role to play in this paradigm shift. The new IMIA President, Professor Antoine Geissbuhler, was announced at the closing ceremony. The next Medinfo congress will take place in Copenhagen, Denmark, in September 2013.
Coggins, Clemency Chase
Formal medical publication began in the United States with The Medical Repository in 1797. Between 1741, the date of the first American magazine, and 1797 medical articles were included in general magazines. This study deals with ten representative magazines and reviews their general content. The varying content of the medical articles is analyzed into broad categories, and several important physicians, contributors to the magazines, are discussed. The Medical Repository is treated as a culmination of eighteenth century medical publication. PMID:14306031
Milic, Natasa M; Ilic, Nikola; Stanisavljevic, Dejana M; Cirkovic, Andja M; Milin, Jelena S; Bukumiric, Zoran M; Milic, Nikola V; Savic, Marko D; Ristic, Sara M; Trajkovic, Goran Z
Education is undergoing profound changes due to permanent technological innovations. This paper reports the results of a pilot study aimed at developing, implementing and evaluating the course, "Applicative Use of Information and Communication Technologies (ICT) in Medicine," upon medical school entry. The Faculty of Medicine, University of Belgrade, introduced a curriculum reform in 2014 that included the implementation of the course, "Applicative Use of ICT in Medicine" for first year medical students. The course was designed using a blended learning format to introduce the concepts of Web-based learning environments. Data regarding student knowledge, use and attitudes towards ICT were prospectively collected for the classes of 2015/16 and 2016/17. The teaching approach was supported by multimedia didactic materials using Moodle LMS. The overall quality of the course was also assessed. The five level Likert scale was used to measure attitudes related to ICT. In total, 1110 students were assessed upon medical school entry. A small number of students (19%) had previous experience with e-learning. Students were largely in agreement that informatics is needed in medical education, and that it is also useful for doctors (4.1±1.0 and 4.1±0.9, respectively). Ability in informatics and use of the Internet in education in the adjusted multivariate regression model were significantly associated with positive student attitudes toward ICT. More than 80% of students stated that they had learned to evaluate medical information and would use the Internet to search medical literature as an additional source for education. The majority of students (77%) agreed that a blended learning approach facilitates access to learning materials and enables time independent learning (72%). Implementing the blended learning course, "Applicative Use of ICT in Medicine," may bridge the gap between medicine and informatics upon medical school entry. Students displayed positive attitudes towards
Lillehaug, S I; Lajoie, S P
The potential benefits of artificial intelligence in medicine (AIM) were never realized as anticipated. This paper addresses ways in which such potential can be achieved. Recent discussions of this topic have proposed a stronger integration between AIM applications and health information systems, and emphasize computer guidelines to support the new health care paradigms of evidence-based medicine and cost-effectiveness. These proposals, however, promote the initial definition of AIM applications as being AI systems that can perform or aid in diagnoses. We challenge this traditional philosophy of AIM and propose a new approach aiming at empowering health care workers to become independent self-sufficient problem solvers and decision makers. Our philosophy is based on findings from a review of empirical research that examines the relationship between the health care personnel's level of knowledge and skills, their job satisfaction, and the quality of the health care they provide. This review supports addressing the quality of health care by empowering health care workers to reach their full potential. As an aid in this empowerment process we argue for reviving a long forgotten AIM research area, namely, AI based applications for medical education and training. There is a growing body of research in artificial intelligence in education that demonstrates that the use of artificial intelligence can enhance learning in numerous domains. By examining the strengths of these educational applications and the results from previous AIM research we derive a framework for empowering medical personnel and consequently raising the quality of health care through the use of advanced AI based technology.
... Publications Journal of Medical Toxicology About ACMT About Us History of ACMT ACMT Fact Sheet Strategic Plan ACMT ... Policies IJMT JMT Editorial Board About ACMT About Us History of ACMT ACMT Fact Sheet Strategic Plan ACMT ...
... we want to offer you and your family good, helpful health information that is based on the very best medical research conducted by and for the National Institutes of Health (NIH). This issue focuses on several topics in which NIH-funded research continues to make ...
Eldredge, Jonathan D; Heskett, Karen M; Henner, Terry; Tan, Josephine P
To conduct a systematic assessment of library and informatics training at accredited Western U.S. medical schools. To provide a structured description of core practices, detect trends through comparisons across institutions, and to identify innovative training approaches at the medical schools. Action research study pursued through three phases. The first phase used inductive analysis on reported library and informatics skills training via publicly-facing websites at accredited medical schools and the academic health sciences libraries serving those medical schools. Phase Two consisted of a survey of the librarians who provide this training to undergraduate medical education students at the Western U.S. medical schools. The survey revealed gaps in forming a complete picture of current practices, thereby generating additional questions that were answered through the Phase Three in-depth interviews. Publicly-facing websites reviewed in Phase One offered uneven information about library and informatics training at Western U.S. medical schools. The Phase Two survey resulted in a 77% response rate. The survey produced a clearer picture of current practices of library and informatics training. The survey also determined the readiness of medical students to pass certain aspects of the United States Medical Licensure Exam. Most librarians interacted with medical school curricular leaders through either curricula committees or through individual contacts. Librarians averaged three (3) interventions for training within the four-year curricula with greatest emphasis upon the first and third years. Library/informatics training was integrated fully into the respective curricula in almost all cases. Most training involved active learning approaches, specifically within Problem-Based Learning or Evidence-Based Medicine contexts. The Phase Three interviews revealed that librarians are engaged with the medical schools' curricular leaders, they are respected for their knowledge and
Mezei, Lina; Murinson, Beth B
Knowledgeable and compassionate care regarding pain is a core responsibility of health professionals associated with better medical outcomes, improved quality of life, and lower healthcare costs. Education is an essential part of training healthcare providers to deliver conscientious pain care but little is known about whether medical school curricula meet educational needs. Using a novel systematic approach to assess educational content, we examined the curricula of Liaison Committee on Medical Education-accredited medical schools between August 2009 and February 2010. Our intent was to establish important benchmark values regarding pain education of future physicians during primary professional training. External validation was performed. Inclusion criteria required evidence of substantive participation in the curriculum management database of the Association of American Medical Colleges. A total of 117 U.S. and Canadian medical schools were included in the study. Approximately 80% of U.S. medical schools require 1 or more pain sessions. Among Canadian medical schools, 92% require pain sessions. Pain sessions are typically presented as part of general required courses. Median hours of instruction on pain topics for Canadian schools was twice the U.S. median. Many topics included in the International Association for the Study of Pain core curriculum received little or no coverage. There were no correlations between the types of pain education offered and school characteristics (eg, private versus public). We conclude that pain education for North American medical students is limited, variable, and often fragmentary. There is a need for innovative approaches and better integration of pain topics into medical school curricula. This study assessed the scope and scale of pain education programs in U.S. and Canadian medical schools. Significant gaps between recommended pain curricula and documented educational content were identified. In short, pain education was
Capurro, Daniel; Soto, Mauricio; Vivent, Macarena; Lopetegui, Marcelo; Herskovic, Jorge R
Biomedical Informatics is a new discipline that arose from the need to incorporate information technologies to the generation, storage, distribution and analysis of information in the domain of biomedical sciences. This discipline comprises basic biomedical informatics, and public health informatics. The development of the discipline in Chile has been modest and most projects have originated from the interest of individual people or institutions, without a systematic and coordinated national development. Considering the unique features of health care system of our country, research in the area of biomedical informatics is becoming an imperative.
Rhoads, Daniel D; Sintchenko, Vitali; Rauch, Carol A; Pantanowitz, Liron
The clinical microbiology laboratory has responsibilities ranging from characterizing the causative agent in a patient's infection to helping detect global disease outbreaks. All of these processes are increasingly becoming partnered more intimately with informatics. Effective application of informatics tools can increase the accuracy, timeliness, and completeness of microbiology testing while decreasing the laboratory workload, which can lead to optimized laboratory workflow and decreased costs. Informatics is poised to be increasingly relevant in clinical microbiology, with the advent of total laboratory automation, complex instrument interfaces, electronic health records, clinical decision support tools, and the clinical implementation of microbial genome sequencing. This review discusses the diverse informatics aspects that are relevant to the clinical microbiology laboratory, including the following: the microbiology laboratory information system, decision support tools, expert systems, instrument interfaces, total laboratory automation, telemicrobiology, automated image analysis, nucleic acid sequence databases, electronic reporting of infectious agents to public health agencies, and disease outbreak surveillance. The breadth and utility of informatics tools used in clinical microbiology have made them indispensable to contemporary clinical and laboratory practice. Continued advances in technology and development of these informatics tools will further improve patient and public health care in the future. Copyright © 2014, American Society for Microbiology. All Rights Reserved.
Otero, P; Hersh, W; Jai Ganesh, A U
The growing volume and diversity of health and biomedical data indicate that the era of Big Data has arrived for healthcare. This has many implications for informatics, not only in terms of implementing and evaluating information systems, but also for the work and training of informatics researchers and professionals. This article addresses the question: What do biomedical and health informaticians working in analytics and Big Data need to know? We hypothesize a set of skills that we hope will be discussed among academic and other informaticians. The set of skills includes: Programming - especially with data-oriented tools, such as SQL and statistical programming languages; Statistics - working knowledge to apply tools and techniques; Domain knowledge - depending on one's area of work, bioscience or health care; and Communication - being able to understand needs of people and organizations, and articulate results back to them. Biomedical and health informatics educational programs must introduce concepts of analytics, Big Data, and the underlying skills to use and apply them into their curricula. The development of new coursework should focus on those who will become experts, with training aiming to provide skills in "deep analytical talent" as well as those who need knowledge to support such individuals.
Kulikowski, Casimir A; Mihalas, George; Greenes, Robert; Yacubsohn, Valerio; Park, Hyeoun-Ae
The IMIA History Working Group has as its first goal the editing of a volume of contributions from pioneers and leaders in the field of biomedical and health informatics (BMHI) to commemorate the 50th anniversary of IMIA's predecessor IFIP-TC4. This paper describes how the IMIA History WG evolved from an earlier Taskforce, and has focused on producing the edited book of original contributions. We describe its proposed outline of objectives for the personal stories, and national and regional society narratives, together with some comments on the evolution of Medinfo meeting contributions over the years, to provide a reference source for the early motivations of the scientific, clinical, educational, and professional changes that have influenced the historical course of our field.
Veinot, Tiffany C; Campbell, Terrance R; Kruger, Daniel J; Grodzinski, Alison
We investigated the user requirements of African-American youth (aged 14-24 years) to inform the design of a culturally appropriate, network-based informatics intervention for the prevention of HIV and other sexually transmitted infections (STI). We conducted 10 focus groups with 75 African-American youth from a city with high HIV/STI prevalence. Data analyses involved coding using qualitative content analysis procedures and memo writing. Unexpectedly, the majority of participants' design recommendations concerned trust. Youth expressed distrust towards people and groups, which was amplified within the context of information technology-mediated interactions about HIV/STI. Participants expressed distrust in the reliability of condoms and the accuracy of HIV tests. They questioned the benevolence of many institutions, and some rejected authoritative HIV/STI information. Therefore, reputational information, including rumor, influenced HIV/STI-related decision making. Participants' design requirements also focused on trust-related concerns. Accordingly, we developed a novel trust-centered design framework to guide intervention design. Current approaches to online trust for health informatics do not consider group-level trusting patterns. Yet, trust was the central intervention-relevant issue among African-American youth, suggesting an important focus for culturally informed design. Our design framework incorporates: intervention objectives (eg, network embeddedness, participation); functional specifications (eg, decision support, collective action, credible question and answer services); and interaction design (eg, member control, offline network linkages, optional anonymity). Trust is a critical focus for HIV/STI informatics interventions for young African Americans. Our design framework offers practical, culturally relevant, and systematic guidance to designers to reach this underserved group better.
Liyanage, H; Liaw, S-T; Di Iorio, C T; Kuziemsky, C; Schreiber, R; Terry, A L; de Lusignan, S
Privacy, ethics, and data access issues pose significant challenges to the timely delivery of health research. Whilst the fundamental drivers to ensure that data access is ethical and satisfies privacy requirements are similar, they are often dealt with in varying ways by different approval processes. To achieve a consensus across an international panel of health care and informatics professionals on an integrated set of privacy and ethics principles that could accelerate health data access in data-driven health research projects. A three-round consensus development process was used. In round one, we developed a baseline framework for privacy, ethics, and data access based on a review of existing literature in the health, informatics, and policy domains. This was further developed using a two-round Delphi consensus building process involving 20 experts who were members of the International Medical Informatics Association (IMIA) and European Federation of Medical Informatics (EFMI) Primary Health Care Informatics Working Groups. To achieve consensus we required an extended Delphi process. The first round involved feedback on and development of the baseline framework. This consisted of four components: (1) ethical principles, (2) ethical guidance questions, (3) privacy and data access principles, and (4) privacy and data access guidance questions. Round two developed consensus in key areas of the revised framework, allowing the building of a newly, more detailed and descriptive framework. In the final round panel experts expressed their opinions, either as agreements or disagreements, on the ethics and privacy statements of the framework finding some of the previous round disagreements to be surprising in view of established ethical principles. This study develops a framework for an integrated approach to ethics and privacy. Privacy breech risk should not be considered in isolation but instead balanced by potential ethical benefit.
Currently, C Hospital lacks a standardized nursing informatics competency program to validate nurses' skills and knowledge in using electronic medical records (EMRs). At the study locale, the organization is about to embark on the implementation of a new, more comprehensive EMR system. All departments will be required to use the new EMR, unlike…
Richesson, Rachel L
This book provides foundational coverage of key areas, concepts, constructs, and approaches of medical informatics as it applies to clinical research activities, in both current settings and in light of emerging policies. The field of clinical research is fully characterized (in terms of study design and overarching business processes), and there is emphasis on information management aspects and informatics implications (including needed activities) within various clinical research environments. The purpose of the book is to provide an overview of clinical research (types), activities, and are
Full Text Available Hereditary diseases and disorders constitute a public health problem. Many people in rural communities of developing countries of the world are particularly ignorant about the cause, modes of transmissions and the treatment plans for such diseases. In some cases, some people lack essential knowledge between common and rare hereditary diseases.It is therefore appropriate and essential to develop a mobile application that will act as an educative resource and a good knowledge base for common and rare hereditary diseases.The aim of this research is to develop AMAHD (Android Mobile Informatics Application for some Hereditary Diseases and Disorders.The objectives of this research are to create an android mobile application that will act as a reference point and provide useful information about various hereditary diseases to medical personnel and professionals; provide additional educational resource to biological and bioinformatics researchers in different higher institutions; and provide a pedagogical, diagnostic and complementary foundational learning tool for African research students in biosciences, bioinformatics, and all other categories of students that currently engage in multidisciplinary research in the aspect of hereditary diseases.Essential data was sourced from relevant literature. We developed AMAHD through an integration of programming languages in Java and XML (Extended Markup Language. SQLite was used to implement the database. We developed a Logical Disjunction Rule-based Algorithm (LDRA for the AMAHDâs diagnosis module.A comparative analysis between existing commercial hereditary mobile applications and AMAHD was conducted and the results presented. A world-wide online survey (spanning Africa, Asia, Europe, America and Australia was conducted to sample the opinion of individuals across the globe on the classification of hereditary diseases as either rare or common, within their respective regions. In addition, an evaluation of
Conceptual and terminological systems are established and maintained by the communities who use them. This paper reports experiments which investigate the role of communication and interaction in the process. The experiments show that isolated pairs of communicators and virtual communities of interacting pairs naturally converge on their own conceptual and terminological systems when confronted with a common task. The results also indicate that the system converged on is optimal for that particular group engaged in that particular task. These findings are discussed in relation to the increasing use of tightly coordinated medical teams and its implications for getting them to adopt standardized medical terminologies.
Kannry, Joseph; Sengstack, Patricia; Thyvalikakath, Thankam Paul; Poikonen, John; Middleton, Blackford; Payne, Thomas; Lehmann, Christoph U
The emerging operational role of the "Chief Clinical Informatics Officer" (CCIO) remains heterogeneous with individuals deriving from a variety of clinical settings and backgrounds. The CCIO is defined in title, responsibility, and scope of practice by local organizations. The term encompasses the more commonly used Chief Medical Informatics Officer (CMIO) and Chief Nursing Informatics Officer (CNIO) as well as the rarely used Chief Pharmacy Informatics Officer (CPIO) and Chief Dental Informatics Officer (CDIO). The American Medical Informatics Association (AMIA) identified a need to better delineate the knowledge, education, skillsets, and operational scope of the CCIO in an attempt to address the challenges surrounding the professional development and the hiring processes of CCIOs. An AMIA task force developed knowledge, education, and operational skillset recommendations for CCIOs focusing on the common core aspect and describing individual differences based on Clinical Informatics focus. The task force concluded that while the role of the CCIO currently is diverse, a growing body of Clinical Informatics and increasing certification efforts are resulting in increased homogeneity. The task force advised that 1.) To achieve a predictable and desirable skillset, the CCIO must complete clearly defined and specified Clinical Informatics education and training. 2.) Future education and training must reflect the changing body of knowledge and must be guided by changing day-to-day informatics challenges. A better defined and specified education and skillset for all CCIO positions will motivate the CCIO workforce and empower them to perform the job of a 21st century CCIO. Formally educated and trained CCIOs will provide a competitive advantage to their respective enterprise by fully utilizing the power of Informatics science.
Tenenbaum, Jessica D; Avillach, Paul; Benham-Hutchins, Marge; Breitenstein, Matthew K; Crowgey, Erin L; Hoffman, Mark A; Jiang, Xia; Madhavan, Subha; Mattison, John E; Nagarajan, Radhakrishnan; Ray, Bisakha; Shin, Dmitriy; Visweswaran, Shyam; Zhao, Zhongming; Freimuth, Robert R
The recent announcement of the Precision Medicine Initiative by President Obama has brought precision medicine (PM) to the forefront for healthcare providers, researchers, regulators, innovators, and funders alike. As technologies continue to evolve and datasets grow in magnitude, a strong computational infrastructure will be essential to realize PM's vision of improved healthcare derived from personal data. In addition, informatics research and innovation affords a tremendous opportunity to drive the science underlying PM. The informatics community must lead the development of technologies and methodologies that will increase the discovery and application of biomedical knowledge through close collaboration between researchers, clinicians, and patients. This perspective highlights seven key areas that are in need of further informatics research and innovation to support the realization of PM. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association.
Hripcsak, George; Forrest, Christopher B; Brennan, Patricia Flatley; Stead, William W
Consistent collection and use of social and behavioral determinants of health can improve clinical care, prevention and general health, patient satisfaction, research, and public health. A recent Institute of Medicine committee defined a panel of 11 domains and 12 measures to be included in electronic health records. Incorporating the panel into practice creates a number of informatics research opportunities as well as challenges. The informatics issues revolve around standardization, efficient collection and review, decision support, and support for research. The informatics community can aid the effort by simultaneously optimizing the collection of the selected measures while also partnering with social science researchers to develop and validate new sources of information about social and behavioral determinants of health. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association.
Clinician‐selected Electronic Information Resources do not Guarantee Accuracy in Answering Primary Care Physicians’ Information Needs. A review of: McKibbon, K. Ann, and Douglas B. Fridsma. “Effectiveness of Clinician‐selected Electronic Information Resources for Answering Primary Care Physicians’ Information Needs.” Journal of the American Medical Informatics Association 13.6 (2006: 653‐9.
Martha Ingrid Preddie
one correct answer was due to the answers from 5 (10.9% questions changing from correct to incorrect, while the answers to 6 questions (13.0% changed from incorrect to correct. The ability to provide correct answers differed among the various resources. Google and Cochrane provided the correct answers about 50% of the time while PubMed, Ovid MEDLINE, UpToDate, Ovid Evidence Based Medicine Reviews and InfoPOEMs were more likely to be associated with incorrect answers. Physicians also seemed unable to determine when they needed to search for informationi n order to make an accurate decision.Conclusion – Clinician‐selected electronic information resources did not guarantee accuracy in the answers provided to simulated clinical questions. At times the use of these resources caused physicians to change self‐determined correct answers to incorrect ones. The authors state that this was possibly due to factors such as poor choice of resources, ineffective search strategies, time constraints and automation bias. Library and information practitioners have an important role to play in identifying and advocating for appropriate information resources to be integrated into the electronic medical record systems provided by healthcare institutions to ensure evidence based health care delivery.
Hinton, Elizabeth G; Oelschlegel, Sandra; Vaughn, Cynthia J; Lindsay, J Michael; Hurst, Sachiko M; Earl, Martha
This study utilizes an informatics tool to analyze a robust literature search service in an academic medical center library. Structured interviews with librarians were conducted focusing on the benefits of such a tool, expectations for performance, and visual layout preferences. The resulting application utilizes Microsoft SQL Server and .Net Framework 3.5 technologies, allowing for the use of a web interface. Customer tables and MeSH terms are included. The National Library of Medicine MeSH database and entry terms for each heading are incorporated, resulting in functionality similar to searching the MeSH database through PubMed. Data reports will facilitate analysis of the search service.
Hsu, William; El-Saden, Suzie; Taira, Ricky K
Imaging is one of the most important sources of clinically observable evidence that provides broad coverage, can provide insight on low-level scale properties, is noninvasive, has few side effects, and can be performed frequently. Thus, imaging data provides a viable observable that can facilitate the instantiation of a theoretical understanding of a disease for a particular patient context by connecting imaging findings to other biologic parameters in the model (e.g., genetic, molecular, symptoms, and patient survival). These connections can help inform their possible states and/or provide further coherent evidence. The field of radiomics is particularly dedicated to this task and seeks to extract quantifiable measures wherever possible. Example properties of investigation include genotype characterization, histopathology parameters, metabolite concentrations, vascular proliferation, necrosis, cellularity, and oxygenation. Important issues within the field include: signal calibration, spatial calibration, preprocessing methods (e.g., noise suppression, motion correction, and field bias correction), segmentation of target anatomic/pathologic entities, extraction of computed features, and inferencing methods connecting imaging features to biological states.
Bronzino, Joseph D
Known as the bible of biomedical engineering, The Biomedical Engineering Handbook, Fourth Edition, sets the standard against which all other references of this nature are measured. As such, it has served as a major resource for both skilled professionals and novices to biomedical engineering.Biomedical Signals, Imaging, and Informatics, the third volume of the handbook, presents material from respected scientists with diverse backgrounds in biosignal processing, medical imaging, infrared imaging, and medical informatics.More than three dozen specific topics are examined, including biomedical s
The rate commitment to ISO 214 standard among the persian abstracts of approved research projects at school of health management and medical informatics, Isfahan University of Medical Sciences, Isfahan, Iran.
Papi, Ahmad; Khalaji, Davoud; Rizi, Hasan Ashrafi; Shabani, Ahmad; Hassanzadeh, Akbar
Commitment to abstracting standards has a very significant role in information retrieval. The present research aimed to evaluate the rate of Commitment to ISO 214 Standard among the Persian abstracts of approved research projects at School of Health Management and Medical Informatics, Isfahan University of Medical Sciences, Isfahan, Iran. This descriptive study used a researcher-made checklist to collect data, which was then analyzed through content analysis. The studied population consisted of 227 approved research projects in the School of Health Management and Medical Informatics, Isfahan University of Medical Sciences during 2001-2010. The validity of the checklist was measured by face and content validity. Data was collected through direct observations. Statistical analyzes including descriptive (frequency distribution and percent) and inferential statistics (Chi-square test) were performed in SPSS-16. The highest and lowest commitment rates to ISO 214 standard were in using third person pronouns (100%) and using active verbs (34/4%), respectively. In addition, the highest commitment rates to ISO 214 standard (100%) related to mentioning third person pronouns, starting the abstract with a sentence to explain the subject of the research, abstract placement, and including keyword in 2009. On the other hand, during 2001-2003, the lowest commitment rate was observed in reporting research findings (16/7%). Moreover, various educational groups differed significantly only in commitment to study goals, providing research findings, and abstaining from using abbreviations, signs, and acronyms. Furthermore, educational level of the corresponding author was significantly related with extracting the keywords from the text. Other factors of ISO 214 standard did not have significant relations with the educational level of the corresponding author. In general, a desirable rate of commitment to ISO 214 standard was observed among the Persian abstracts of approved research
... the "March of Dimes." It helped develop two vaccines. The first, by Dr. Jonas Salk at the University of Pittsburgh, in 1955, and the second, in 1962, by Dr. Albert Sabin, at the Cincinnati Children's Hospital Medical Center – have ...
Fetterolf, Donald; Brodie, Bridget
The American College of Medical Quality is a national organization of health care professionals who are interested in the advancement of medical quality as a field. Composed primarily of doctorate-level individuals in medicine, dentistry, and podiatry, it also includes affiliate members in preprofessional training as well as nursing. Origins of the organization date to 1973, when it was first called the American College of Utilization Review Physicians. It is formally recognized by the American Medical Association and holds a seat in its House of Delegates. The College views the advancement of medical quality as a field of study within itself and offers multiple venues for self-education, testing, and professional networking for its members. Recently, rising national awareness of quality in health care as a field of endeavor has elevated enrollment levels and increased interest in the organization.
Samuel, Hamman W; Zaïane, Osmar R
We present a searchable repository of codes of ethics and standards in health informatics. It is built using state-of-the-art search algorithms and technologies. The repository will be potentially beneficial for public health practitioners, researchers, and software developers in finding and comparing ethics topics of interest. Public health clinics, clinicians, and researchers can use the repository platform as a one-stop reference for various ethics codes and standards. In addition, the repository interface is built for easy navigation, fast search, and side-by-side comparative reading of documents. Our selection criteria for codes and standards are two-fold; firstly, to maintain intellectual property rights, we index only codes and standards freely available on the internet. Secondly, major international, regional, and national health informatics bodies across the globe are surveyed with the aim of understanding the landscape in this domain. We also look at prevalent technical standards in health informatics from major bodies such as the International Standards Organization (ISO) and the U. S. Food and Drug Administration (FDA). Our repository contains codes of ethics from the International Medical Informatics Association (IMIA), the iHealth Coalition (iHC), the American Health Information Management Association (AHIMA), the Australasian College of Health Informatics (ACHI), the British Computer Society (BCS), and the UK Council for Health Informatics Professions (UKCHIP), with room for adding more in the future. Our major contribution is enhancing the findability of codes and standards related to health informatics ethics by compilation and unified access through the health informatics ethics repository.
The American Society of Health- System Pharmacists (ASHP) believes that specially trained pharmacy technicians can assume important supportive roles in pharmacy informatics. These roles include automation and technology systems management, management of projects, training and education, policy and governance, customer service, charge integrity, and reporting. Such roles require pharmacy technicians to gain expertise in information technology (IT) systems, including knowledge of interfaces, computer management techniques, problem resolution, and database maintenance. This knowledge could be acquired through specialized training or experience in a health science or allied scientific field (e.g., health informatics). With appropriate safeguards and supervision, pharmacy technician informaticists (PTIs) will manage IT processes in health-system pharmacy services, ensuring a safe and efficient medication-use process.
Gruppen, Larry D; Yoder, Ernie; Frye, Ann; Perkowski, Linda C; Mavis, Brian
The quality of the medical education research (MER) reported in the literature has been frequently criticized. Numerous reasons have been provided for these shortcomings, including the level of research training and experience of many medical school faculty. The faculty development required to improve MER can take various forms. This article describes the Medical Education Research Certificate (MERC) program, a national faculty development program that focuses exclusively on MER. Sponsored by the Association of American Medical Colleges and led by a committee of established medical education researchers from across the United States, the MERC program is built on a set of 11 interactive workshops offered at various times and places across the United States. MERC participants can customize the program by selecting six workshops from this set to fulfill requirements for certification. This article describes the history, operations, current organization, and evaluation of the program. Key elements of the program's success include alignment of program content and focus with needs identified by prospective users, flexibility in program organization and logistics to fit participant schedules, an emphasis on practical application of MER principles in the context of the participants' activities and interests, consistency in program content and format to ensure standards of quality, and a sustainable financial model. The relationship between the national MERC program and local faculty development initiatives is also described. The success of the MERC program suggests that it may be a possible model for nationally disseminated faculty development programs in other domains.
McCoy, Allison B; Wright, Adam; Wattanasin, Nich; Sittig, Dean F; Murphy, Shawn N
Background The Strategic Health IT Advanced Research Projects (SHARP) program seeks to conquer well-understood challenges in medical informatics through breakthrough research. Two SHARP centers have found alignment in their methodological needs: (1) members of the National Center for Cognitive Informatics and Decision-making (NCCD) have developed knowledge bases to support problem-oriented summarizations of patient data, and (2) Substitutable Medical Apps, Reusable Technologies (SMART), which is a platform for reusable medical apps that can run on participating platforms connected to various electronic health records (EHR). Combining the work of these two centers will ensure wide dissemination of new methods for synthesized views of patient data. Informatics for Integrating Biology and the Bedside (i2b2) is an NIH-funded clinical research data repository platform in use at over 100 sites worldwide. By also working with a co-occurring initiative to SMART-enabling i2b2, we can confidently write one app that can be used extremely broadly. Objective Our goal was to facilitate development of intuitive, problem-oriented views of the patient record using NCCD knowledge bases that would run in any EHR. To do this, we developed a collaboration between the two SHARPs and an NIH center, i2b2. Methods First, we implemented collaborative tools to connect researchers at three institutions. Next, we developed a patient summarization app using the SMART platform and a previously validated NCCD problem-medication linkage knowledge base derived from the National Drug File-Reference Terminology (NDF-RT). Finally, to SMART-enable i2b2, we implemented two new Web service “cells” that expose the SMART application programming interface (API), and we made changes to the Web interface of i2b2 to host a “carousel” of SMART apps. Results We deployed our SMART-based, NDF-RT-derived patient summarization app in this SMART-i2b2 container. It displays a problem-oriented view of
Klann, Jeffrey G; McCoy, Allison B; Wright, Adam; Wattanasin, Nich; Sittig, Dean F; Murphy, Shawn N
The Strategic Health IT Advanced Research Projects (SHARP) program seeks to conquer well-understood challenges in medical informatics through breakthrough research. Two SHARP centers have found alignment in their methodological needs: (1) members of the National Center for Cognitive Informatics and Decision-making (NCCD) have developed knowledge bases to support problem-oriented summarizations of patient data, and (2) Substitutable Medical Apps, Reusable Technologies (SMART), which is a platform for reusable medical apps that can run on participating platforms connected to various electronic health records (EHR). Combining the work of these two centers will ensure wide dissemination of new methods for synthesized views of patient data. Informatics for Integrating Biology and the Bedside (i2b2) is an NIH-funded clinical research data repository platform in use at over 100 sites worldwide. By also working with a co-occurring initiative to SMART-enabling i2b2, we can confidently write one app that can be used extremely broadly. Our goal was to facilitate development of intuitive, problem-oriented views of the patient record using NCCD knowledge bases that would run in any EHR. To do this, we developed a collaboration between the two SHARPs and an NIH center, i2b2. First, we implemented collaborative tools to connect researchers at three institutions. Next, we developed a patient summarization app using the SMART platform and a previously validated NCCD problem-medication linkage knowledge base derived from the National Drug File-Reference Terminology (NDF-RT). Finally, to SMART-enable i2b2, we implemented two new Web service "cells" that expose the SMART application programming interface (API), and we made changes to the Web interface of i2b2 to host a "carousel" of SMART apps. We deployed our SMART-based, NDF-RT-derived patient summarization app in this SMART-i2b2 container. It displays a problem-oriented view of medications and presents a line-graph display of
Kamin, Carol; Souza, Kevin H; Heestand, Diane; Moses, Anna; O'Sullivan, Patricia
To describe the current educational technology infrastructure and services provided by North American allopathic medical schools that are members of the Association of American Medical Colleges (AAMC), to present information needed for institutional benchmarking. A Web-based survey instrument was developed and administered in the fall of 2004 by the authors, sent to representatives of 137 medical schools and completed by representatives of 88, a response rate of 64%. Schools were given scores for infrastructure and services provided. Data were analyzed with one-way analyses of variance, chi-square, and correlation coefficients. There was no difference in the number of infrastructure features or services offered based on region of the country, public versus private schools, or size of graduating class. Schools implemented 3.0 (SD = 1.5) of 6 infrastructure items and offered 11.6 (SD = 4.1) of 22 services. Over 90% of schools had wireless access (97%), used online course materials for undergraduate medical education (97%), course management system for graduate medical education (95%) and online teaching evaluations (90%). Use of services differed across the undergraduate, graduate, and continuing medical education continuum. Outside of e-portfolios for undergraduates, the least-offered services were for services to graduate and continuing medical education. The results of this survey provide a benchmark for the level of services and infrastructure currently supporting educational technology by AAMC-member allopathic medical schools.
Smith, K R
This article examines an informatics system developed for outcomes management of the mechanically ventilated adult population, focusing on weaning the patient from mechanical ventilation. The link between medical informatics and outcomes management is discussed, along with the development of methods, tools, and data sets for outcomes management of the mechanically ventilated adult population at an acute care academic institution. Pros and cons of this system are identified, and specific areas for improvement of future health care outcomes medical informatics systems are discussed.
龙艺; 田宗远; 陈龙
医学信息化技术广泛地应用于现代医疗各个环节之中,其具有高效、私密和功利性等特征,同时也产生了一些伦理问题.这些伦理问题折射了部分医务工作者对此缺乏足够的重视、对信息化技术的特点缺乏应有的认识、医疗机构对此缺少防范技术和监管等问题.对于信息技术所导致的伦理问题,应当从加强立法、强化和规范医院的管理、加强医疗机构和医务工作者的教育等方面抓起,化解现代医学信息化中的伦理问题.%Medical information technology has been widely used in modern medicine,with high efficiency,privacy and utilitarian characteristics.However,it has brought many relevant ethical issues which reflect the less attention,knowledge deficit and lacking prevention technology and regulation in some medical workers and some medical institutions.Dealing with these ethical problems caused by information technology,we should strengthen legislation,strengthen and regulate the management of hospitals,strengthen the corresponding education in medical institutions,in order to solve ethical problems in modem medical informatization.
Sanchez-Pinto, L Nelson; Mosa, Abu S M; Fultz-Hollis, Kate; Tachinardi, Umberto; Barnett, William K; Embi, Peter J
The role of the Chief Research Informatics Officer (CRIO) is emerging in academic health centers to address the challenges clinical researchers face in the increasingly digitalized, data-intensive healthcare system. Most current CRIOs are the first officers in their institutions to hold that role. To date there is very little published information about this role and the individuals who serve it. To increase our understanding of the CRIO role, the leaders who serve it, and the factors associated with their success in their organizations. The Clinical Research Informatics Working Group of the American Medical Informatics Association (AMIA) conducted a national survey of CRIOs in the United States and convened an expert panel of CRIOs to discuss their experience during the 2016 AMIA Annual Symposium. CRIOs come from diverse academic backgrounds. Most have advance training and extensive experience in biomedical informatics but the majority have been CRIOs for less than three years. CRIOs identify funding, data governance, and advancing data analytics as their major challenges. CRIOs play an important role in helping shape the future of clinical research, innovation, and data analytics in healthcare in their organizations. They share many of the same challenges and see the same opportunities for the future of the field. Better understanding the background and experience of current CRIOs can help define and develop the role in other organizations and enhance their influence in the field of research informatics.
Cantor, Michael N
Translational informatics (TI) is extremely important for the pharmaceutical industry, especially as the bar for regulatory approval of new medications is set higher and higher. This paper will explore three specific areas in the drug development lifecycle, from tools developed by precompetitive consortia to standardized clinical data collection to the effective delivery of medications using clinical decision support, in which TI has a major role to play. Advancing TI will require investment in new tools and algorithms, as well as ensuring that translational issues are addressed early in the design process of informatics projects, and also given higher weight in funding or publication decisions. Ultimately, the source of translational tools and differences between academia and industry are secondary, as long as they move towards the shared goal of improving health.
Shkirkova, Kristina; Akam, Eftitan Y; Huang, Josephine; Sheth, Sunil A; Nour, May; Liang, Conrad W; McManus, Michael; Trinh, Van; Duckwiler, Gary; Tarpley, Jason; Vinuela, Fernando; Saver, Jeffrey L
Background Rapid dissemination and coordination of clinical and imaging data among multidisciplinary team members are essential for optimal acute stroke care. Aim To characterize the feasibility and utility of the Synapse Emergency Room mobile (Synapse ERm) informatics system. Methods We implemented the Synapse ERm system for integration of clinical data, computerized tomography, magnetic resonance, and catheter angiographic imaging, and real-time stroke team communications, in consecutive acute neurovascular patients at a Comprehensive Stroke Center. Results From May 2014 to October 2014, the Synapse ERm application was used by 33 stroke team members in 84 Code Stroke alerts. Patient age was 69.6 (±17.1), with 41.5% female. Final diagnosis was: ischemic stroke 64.6%, transient ischemic attack 7.3%, intracerebral hemorrhage 6.1%, and cerebrovascular-mimic 22.0%. Each patient Synapse ERm record was viewed by a median of 10 (interquartile range 6-18) times by a median of 3 (interquartile range 2-4) team members. The most used feature was computerized tomography, magnetic resonance, and catheter angiography image display. In-app tweet team, communications were sent by median 1 (interquartile range 0-1, range 0-13) users per case and viewed by median 1 (interquartile range 0-3, range 0-44) team members. Use of the system was associated with rapid treatment times, faster than national guidelines, including median door-to-needle 51.0 min (interquartile range 40.5-69.5) and median door-to-groin 94.5 min (interquartile range 85.5-121.3). In user surveys, the mobile information platform was judged easy to employ in 91% (95% confidence interval 65%-99%) of uses and of added help in stroke management in 50% (95% confidence interval 22%-78%). Conclusion The Synapse ERm mobile platform for stroke team distribution and integration of clinical and imaging data was feasible to implement, showed high ease of use, and moderate perceived added utility in therapeutic management.
R Michele Anholt
Full Text Available Antimicrobial drugs may be used to treat diarrheal illness in companion animals. It is important to monitor antimicrobial use to better understand trends and patterns in antimicrobial resistance. There is no monitoring of antimicrobial use in companion animals in Canada. To explore how the use of electronic medical records could contribute to the ongoing, systematic collection of antimicrobial use data in companion animals, anonymized electronic medical records were extracted from 12 participating companion animal practices and warehoused at the University of Calgary. We used the pre-diagnostic, clinical features of diarrhea as the case definition in this study. Using text-mining technologies, cases of diarrhea were described by each of the following variables: diagnostic laboratory tests performed, the etiological diagnosis and antimicrobial therapies. The ability of the text miner to accurately describe the cases for each of the variables was evaluated. It could not reliably classify cases in terms of diagnostic tests or etiological diagnosis; a manual review of a random sample of 500 diarrhea cases determined that 88/500 (17.6% of the target cases underwent diagnostic testing of which 36/88 (40.9% had an etiological diagnosis. Text mining, compared to a human reviewer, could accurately identify cases that had been treated with antimicrobials with high sensitivity (92%, 95% confidence interval, 88.1%-95.4% and specificity (85%, 95% confidence interval, 80.2%-89.1%. Overall, 7400/15,928 (46.5% of pets presenting with diarrhea were treated with antimicrobials. Some temporal trends and patterns of the antimicrobial use are described. The results from this study suggest that informatics and the electronic medical records could be useful for monitoring trends in antimicrobial use.
In American medical schools, the period of time between the announcement of internships and graduation is known as FYBIGMI, for "Fuck You Brother I Got My Internship." At University Medical School (pseudonym), as at most American medical schools, this period culminates in an elaborate musical comedy (attended by faculty and relatives) in which faculty are abused, patients are represented in terms of stigmatized stereotypes, and the students demonstrate a profane familiarity with cultural taboos. Using the analytic methods of cultural anthropology, this examination of the FYBIGMI performance at U.M.S. focuses primarily on the seniors' presentation of their newly acquired professional identity, which is constituted in the skits by recurring oppositions to socially stigmatized, medically self-destructive patients. In this oppositional logic, racial stereotypes play a particularly large role. In addition, the seniors establish their new social status by inverting their relationship to their (former) supervisors on a personal basis, and by confronting the audience with their professional ability to treat cultural taboos with profane familiarity. The FYBIGMI theatrical, and its representation of professional identity, is analyzed in relation to a proposed model of the underlying structure of the process of medical education, that is, an escalating dialectic of intimidation and self-congratulation.
Unertl, Kim M; Schaefbauer, Chris L; Campbell, Terrance R; Senteio, Charles; Siek, Katie A; Bakken, Suzanne; Veinot, Tiffany C
We compare 5 health informatics research projects that applied community-based participatory research (CBPR) approaches with the goal of extending existing CBPR principles to address issues specific to health informatics research. We conducted a cross-case analysis of 5 diverse case studies with 1 common element: integration of CBPR approaches into health informatics research. After reviewing publications and other case-related materials, all coauthors engaged in collaborative discussions focused on CBPR. Researchers mapped each case to an existing CBPR framework, examined each case individually for success factors and barriers, and identified common patterns across cases. Benefits of applying CBPR approaches to health informatics research across the cases included the following: developing more relevant research with wider impact, greater engagement with diverse populations, improved internal validity, more rapid translation of research into action, and the development of people. Challenges of applying CBPR to health informatics research included requirements to develop strong, sustainable academic-community partnerships and mismatches related to cultural and temporal factors. Several technology-related challenges, including needs to define ownership of technology outputs and to build technical capacity with community partners, also emerged from our analysis. Finally, we created several principles that extended an existing CBPR framework to specifically address health informatics research requirements. Our cross-case analysis yielded valuable insights regarding CBPR implementation in health informatics research and identified valuable lessons useful for future CBPR-based research. The benefits of applying CBPR approaches can be significant, particularly in engaging populations that are typically underserved by health care and in designing patient-facing technology. © The Authors 2015. Published by Oxford University Press on behalf of the American Medical
Abraham, Tara H
As American psychiatrists moved from the asylum to the private clinic during the early twentieth century, psychiatry acquired a growing presence within medical school curricula. This shift in disciplinary status took place at a time when medical education itself was experiencing a period of reform. By examining medical school registers at Harvard University, records from the Dean's office of Harvard's medical school, and oral histories, this paper examines the rise in prominence of psychiatry in medical education. Three builders of Harvard psychiatry - Elmer E. Southard, C. Macfie Campbell, and Harry C. Solomon - simultaneously sought to mark territory for psychiatry and its relevance. In doing so, they capitalized on three related elements: the fluidity that existed between psychiatry and neurology, the new venues whereby medical students gained training in psychiatry, and the broader role of patrons, professional associations, and certification boards, which sought to expand psychiatry's influence in the social and cultural life of twentieth-century America.
Jun, Jungmi; Oh, Kyeung Mi
This study examines Korean American community newspapers' representation of risks and benefits involved with medical tourism offered in Korea. Using framing theory, this research attempts to explain Korean Americans' highly positive perceptions and high willingness to use health and medical services in Korea through medical tourism rather than using such services in the United States. The result of content analyses indicated that Korean American community newspapers are rarely engaged in risk communication and lack sufficient information about potential risks of medical tourism while emphasizing diverse benefits. Korean ethnic media, as the primary source of health communication for Korean Americans, should provide more reliable health and medical information for the population's appropriate health management.
Joshi, Ashish; Perin, Douglas Marcel Puricelli
The objective of this study was to explore public health informatics (PHI) training programs that currently exist to meet the growing demand for a trained global workforce. We used several search engines, scientific databases, and the websites of informatics organizations; sources included PubMed, Google, the American Medical Informatics Organization, and the International Medical Informatics Organization. The search was conducted from May to July 2011 and from January to February 2012 using key words such as informatics, public health informatics, or biomedical informatics along with academic programs, training, certificate, graduate programs, or postgraduate programs. Course titles and catalog descriptions were gathered from the program or institution websites. Variables included PHI program categories, location and mode of delivery, program credits, and costs. Each course was then categorized based on its title and description as available on the Internet. Finally, we matched course titles and descriptions with the competencies for PHIs determined by Centers for Disease Control and Prevention (CDC). Descriptive analysis was performed to report means and frequency distributions for continuous and categorical variables. Stratified analysis was performed to explore average credits and cost per credit among both the public and private institutions. Fifteen PHI programs were identified across 13 different institutions, the majority of which were US-based. The average number of credits and the associated costs required to obtain PHI training were much higher in private as compared to public institutions. The study results suggest that a need for online contextual and cost-effective PHI training programs exists to address the growing needs of professionals worldwide who are using technology to improve public health in their respective countries.
Otero, P; Hersh, W
Web 3.0 is transforming the World Wide Web by allowing knowledge and reasoning to be gleaned from its content. Describe a new scenario in education and training known as "Education 3.0" that can help in the promotion of learning in health informatics in a collaborative way. Review of the current standards available for curricula and learning activities in in Biomedical and Health Informatics (BMHI) for a Web 3.0 scenario. A new scenario known as "Education 3.0" can provide open educational resources created and reused throughout different institutions and improved by means of an international collaborative knowledge powered by the use of E-learning. Currently there are standards that could be used in identifying and deliver content in education in BMHI in the semantic web era such as Resource Description Format (RDF), Web Ontology Language (OWL) and Sharable Content Object Reference Model (SCORM). In addition, there are other standards to support healthcare education and training. There are few experiences in the use of standards in e-learning in BMHI published in the literature. Web 3.0 can propose new approaches to building the BMHI workforce so there is a need to build tools as knowledge infrastructure to leverage it. The usefulness of standards in the content and competencies of training programs in BMHI needs more experience and research so as to promote the interoperability and sharing of resources in this growing discipline.
Seidel, Erica; Crowe, Scott
This study was designed to: (1) determine how many American medical schools include disability awareness in their curriculum, (2) explore the format of disability awareness programs in existence, and (3) understand why some schools do not include disability awareness in their curriculum. An online survey was sent to deans of medical education (or equivalent positions) at accredited allopathic and osteopathic American medical schools (N = 167) in 2015. Seventy-five schools (45%) completed surveys. Fifty-two percent (39/75) reported having a disability awareness program. The most common format was people with disabilities or caregivers speaking in a large group setting. Programs were most likely to focus on adults with physical disabilities. Among schools without a program, the top barriers were no one advocating for inclusion in the curriculum and time constraints. Nearly half of schools without a program expressed interest in adopting an awareness curriculum if one was made available. Such results indicate that efforts should be made to increase the number of schools that provide disability awareness education through increased advocacy and providing additional resources to schools without a curriculum.
А А Меджидова
Full Text Available The article draws attention to the fact that the Informatization of primary education is a uniform process, in which I the first turn mathematics and computer science are associated. Learning these disciplines is in natural interrelation and this comes from the nature of these disciplines. But in other subjects both mathematics and computer science play an applied role. It is proved that at the modern stage of Informatization in education contributes to improving the quality of assimilated knowledge acquired and skills.The article touches upon issues that reveal the relevance of the subject of Informatics in education. In connection with the information development there is a need of Informatization of education and society as a whole. The basic concepts of Informatics as a scientific and academic discipline are shown. Set out the subject, object and objectives of teaching science. Methodical program of the subject, aimed to develop school education is also considered.
Shen, Ying; Colloc, Joël; Jacquet-Andrieu, Armelle; Lei, Kai
This research aims to depict the methodological steps and tools about the combined operation of case-based reasoning (CBR) and multi-agent system (MAS) to expose the ontological application in the field of clinical decision support. The multi-agent architecture works for the consideration of the whole cycle of clinical decision-making adaptable to many medical aspects such as the diagnosis, prognosis, treatment, therapeutic monitoring of gastric cancer. In the multi-agent architecture, the ontological agent type employs the domain knowledge to ease the extraction of similar clinical cases and provide treatment suggestions to patients and physicians. Ontological agent is used for the extension of domain hierarchy and the interpretation of input requests. Case-based reasoning memorizes and restores experience data for solving similar problems, with the help of matching approach and defined interfaces of ontologies. A typical case is developed to illustrate the implementation of the knowledge acquisition and restitution of medical experts. Copyright © 2015 Elsevier Inc. All rights reserved.
Rowen, Tami S.; Smith, James F.; Eisenberg, Michael L.; Breyer, Benjamin N.; Drey, Eleanor A.; Shindel, Alan W.
Background Previous studies indicate that the sexual beliefs and mores of students in medical professions may influence their capacity to care for patients’ sexuality and contraception issues. Students also represent a large sample of reproductive-age individuals. In this study, we examined contraceptive usage patterns in North American medical students. Study Design Students using online medical student social and information networks enrolled in allopathic and osteopathic medical schools in North America between February and July of 2008 were invited to participate via email and published announcements in an Internet-based survey consisting of a questionnaire that assessed ethnodemographic factors, year in school and sexual history. We also collected information about current use of contraceptive and barrier methods. Descriptive statistics and logistic regression were utilized to analyze responses. Results Among our 2269 complete responses, at least one form of contraception was being utilized by 71% of men and 76% of women. Condoms were the most popular form of contraceptive, utilized by 1011 respondents (50% of men and 40% of women). Oral contraceptive pills were the contraceptive of choice for 34% of men and 41% of women. Decreased rates of contraception use were associated with being black or Asian, not being in a relationship and having more sexual dysfunction in female respondents. Students who reported comfort discussing sexual issues with patients were more likely to use effective contraceptive methods themselves. Ten percent of this of sexually active medical students was not currently using contraception. Conclusions There are significant differences in contraceptive use based on demographics, even at the highest education levels. The personal contraception choices of medical students may influence their ability to accurately convey information about contraception to their patients. In addition, medical students may personally benefit from improved
Gartrell, Kyungsook; Trinkoff, Alison M; Storr, Carla L; Wilson, Marisa L
An electronic personal health record is a patient-centric tool that enables patients to securely access, manage, and share their health information with healthcare providers. It is presumed the nursing informatics community would be early adopters of electronic personal health record, yet no studies have been identified that examine the personal adoption of electronic personal health record's for their own healthcare. For this study, we sampled nurse members of the American Medical Informatics Association and the Healthcare Information and Management Systems Society with 183 responding. Multiple logistic regression analysis was used to identify those factors associated with electronic personal health record use. Overall, 72% were electronic personal health record users. Users tended to be older (aged >50 years), be more highly educated (72% master's or doctoral degrees), and hold positions as clinical informatics specialists or chief nursing informatics officers. Those whose healthcare providers used electronic health records were significantly more likely to use electronic personal health records (odds ratio, 5.99; 95% confidence interval, 1.40-25.61). Electronic personal health record users were significantly less concerned about privacy of health information online than nonusers (odds ratio, 0.32; 95% confidence interval, 0.14-0.70) adjusted for ethnicity, race, and practice region. Informatics nurses, with their patient-centered view of technology, are in prime position to influence development of electronic personal health records. Our findings can inform policy efforts to encourage informatics and other professional nursing groups to become leaders and users of electronic personal health record; such use could help them endorse and engage patients to use electronic personal health records. Having champions with expertise in and enthusiasm for the new technology can promote the adoptionof electronic personal health records among healthcare providers as well as
Elkin, P L; Brown, S H; Wright, G
This article is part of a For-Discussion-Section of Methods of Information in Medicine on "Biomedical Informatics: We are what we publish". It is introduced by an editorial and followed by a commentary paper with invited comments. In subsequent issues the discussion may continue through letters to the editor. Informatics experts have attempted to define the field via consensus projects which has led to consensus statements by both AMIA. and by IMIA. We add to the output of this process the results of a study of the Pubmed publications with abstracts from the field of Biomedical Informatics. We took the terms from the AMIA consensus document and the terms from the IMIA definitions of the field of Biomedical Informatics and combined them through human review to create the Health Informatics Ontology. We built a terminology server using the Intelligent Natural Language Processor (iNLP). Then we downloaded the entire set of articles in Medline identified by searching the literature by "Medical Informatics" OR "Bioinformatics". The articles were parsed by the joint AMIA / IMIA terminology and then again using SNOMED CT and for the Bioinformatics they were also parsed using HGNC Ontology. We identified 153,580 articles using "Medical Informatics" and 20,573 articles using "Bioinformatics". This resulted in 168,298 unique articles and an overlap of 5,855 articles. Of these 62,244 articles (37%) had titles and abstracts that contained at least one concept from the Health Informatics Ontology. SNOMED CT indexing showed that the field interacts with most all clinical fields of medicine. Further defining the field by what we publish can add value to the consensus driven processes that have been the mainstay of the efforts to date. Next steps should be to extract terms from the literature that are uncovered and create class hierarchies and relationships for this content. We should also examine the high occurring of MeSH terms as markers to define Biomedical Informatics
E-mailed Evidence Based Summaries Impact Physician Learning More than Practice. A Review of: Grad, Roland M., Pierre Pluye, Jay Mercer, Bernard Marlow, Marie Eve Beauchamp, Michael Shulha, Janique Johnson-Lafleur and Sharon Wood-Dauphinee. “Impact of Research-based Synopses Delivered as Daily E-mail: A Prospective Observational Study.” Journal of the American Medical Informatics Association (200815.2: 240-5.
Gale G. Hannigan
Full Text Available Objective – To determine the use and construct validity of a method to assess the cognitive impact of information derived from daily e-mail evidence based summaries (InfoPOEMs, and to describe the self-reported impact of these InfoPOEMs.Design – Prospective, observational study over a period of 150 days employing a questionnaire and rating scale.Setting – This study was conducted via the Internet between September 8, 2006 and February 4, 2007.Subjects – Canadian Medical Association (CMA members who received InfoPOEMs via e-mail as of September 2006 were invited to participate. For inclusion in the analyses, a participant was defined as a practising family physician or general practitioner who submitted at least five ratings of InfoPOEMS during the study period (n=1,007.Methods – Volunteers completed a demographic questionnaire and provided informed consent online. Each subsequent InfoPOEM delivered included a link to a “ten-item impact assessment scale” (241. Participants checked “all that apply” of descriptive statements such as: My practice was (will be improved; I learned something new; I think this information is potentially harmful. Each combination of selections made was considered a pattern of cognitive impact. College of Family Physicians of Canada received continuing medical education (CME credit for each InfoPOEM rated. Data were collected by the CMA and forwarded weekly to the investigators who used descriptive statistics, principal component analysis, and multilevel factor analysis to analyze the data.Main Results – 1,007 participants rated an average of 61 InfoPOEMs (ranging from five to 111. A total of 61,493 patterns of cognitive impact were submitted. Eighty-five different patterns were observed, i.e., there were 85 different combinations of the scale’s statements used. Ten patterns accounted for 89.4% of the reports. The top five patterns were: I learned something new (35.2%; No impact (17.1%; This
Marshall, Nina L
A preliminary audit of orders for computed tomography was performed to evaluate the typical performance of interns ordering radiologic examinations. According to the audit, the interns showed only minimal improvement after 8 months of work experience. The online radiology ordering module (ROM) program included baseline assessment of student performance (part I), online learning with the ROM (part II), and follow-up assessment of performance with simulated ordering with the ROM (part III). A curriculum blueprint determined the content of the ROM program, with an emphasis on practical issues, including provision of logistic information, clinical details, and safety-related information. Appropriate standards were developed by a committee of experts, and detailed scoring systems were devised for assessment. The ROM program was successful in addressing practical issues in a simulated setting. In the part I assessment, the mean score for noting contraindications for contrast media was 24%; this score increased to 59% in the part III assessment (P = .004). Similarly, notification of methicillin-resistant Staphylococcus aureus status and pregnancy status and provision of referring physician contact information improved significantly. The quality of the clinical notes was stable, with good initial scores. Part III testing showed overall improvement, with the mean score increasing from 61% to 76% (P < .0001). In general, medical students lack the core knowledge that is needed for good-quality ordering of radiology services, and the experience typically afforded to interns does not address this lack of knowledge. The ROM program was a successful intervention that resulted in statistically significant improvements in the quality of radiologic examination orders, particularly with regard to logistic and radiation safety issues.
Full Text Available This editorial provides insights into how informatics can attract highly trained students by involving them in science, technology, engineering, and math (STEM training at the high school level and continuing to provide mentorship and research opportunities through the formative years of their education. Our central premise is that the trajectory necessary to be expert in the emergent fields in front of them requires acceleration at an early time point. Both pathology (and biomedical informatics are new disciplines which would benefit from involvement by students at an early stage of their education. In 2009, Michael T Lotze MD, Kirsten Livesey (then a medical student, now a medical resident at University of Pittsburgh Medical Center (UPMC, Richard Hersheberger, PhD (Currently, Dean at Roswell Park, and Megan Seippel, MS (the administrator launched the University of Pittsburgh Cancer Institute (UPCI Summer Academy to bring high school students for an 8 week summer academy focused on Cancer Biology. Initially, pathology and biomedical informatics were involved only in the classroom component of the UPCI Summer Academy. In 2011, due to popular interest, an informatics track called Computer Science, Biology and Biomedical Informatics (CoSBBI was launched. CoSBBI currently acts as a feeder program for the undergraduate degree program in bioinformatics at the University of Pittsburgh, which is a joint degree offered by the Departments of Biology and Computer Science. We believe training in bioinformatics is the best foundation for students interested in future careers in pathology informatics or biomedical informatics. We describe our approach to the recruitment, training and research mentoring of high school students to create a pipeline of exceptionally well-trained applicants for both the disciplines of pathology informatics and biomedical informatics. We emphasize here how mentoring of high school students in pathology informatics and biomedical
Dutta-Moscato, Joyeeta; Gopalakrishnan, Vanathi; Lotze, Michael T; Becich, Michael J
This editorial provides insights into how informatics can attract highly trained students by involving them in science, technology, engineering, and math (STEM) training at the high school level and continuing to provide mentorship and research opportunities through the formative years of their education. Our central premise is that the trajectory necessary to be expert in the emergent fields in front of them requires acceleration at an early time point. Both pathology (and biomedical) informatics are new disciplines which would benefit from involvement by students at an early stage of their education. In 2009, Michael T Lotze MD, Kirsten Livesey (then a medical student, now a medical resident at University of Pittsburgh Medical Center (UPMC)), Richard Hersheberger, PhD (Currently, Dean at Roswell Park), and Megan Seippel, MS (the administrator) launched the University of Pittsburgh Cancer Institute (UPCI) Summer Academy to bring high school students for an 8 week summer academy focused on Cancer Biology. Initially, pathology and biomedical informatics were involved only in the classroom component of the UPCI Summer Academy. In 2011, due to popular interest, an informatics track called Computer Science, Biology and Biomedical Informatics (CoSBBI) was launched. CoSBBI currently acts as a feeder program for the undergraduate degree program in bioinformatics at the University of Pittsburgh, which is a joint degree offered by the Departments of Biology and Computer Science. We believe training in bioinformatics is the best foundation for students interested in future careers in pathology informatics or biomedical informatics. We describe our approach to the recruitment, training and research mentoring of high school students to create a pipeline of exceptionally well-trained applicants for both the disciplines of pathology informatics and biomedical informatics. We emphasize here how mentoring of high school students in pathology informatics and biomedical informatics
Klugman, Craig M
Although the AAMC requires annual reporting of medical humanities teaching, most literature is based on single-school case reports and studies using information reported on schools' websites. This study sought to discover what medical humanities is offered in North American allopathic and osteopathic undergraduate medical schools. An 18-question, semi-structured survey was distributed to all 146 (as of June 2016) member schools of the American Association of Medical Colleges and the American Association of Colleges of Osteopathic Medicine. The survey sought information on required and elective humanities content, hours of humanities instruction, types of disciplines, participation rates, and humanities administrative structure. The survey was completed by 134 schools (145 AAMC; 31 AACOM). 70.8% of schools offered required and 80.6% offered electives in humanities. Global health and writing were the most common disciplines. Schools required 43.9 mean (MD 45.4; DO 37.1) and 30 (MD 29; DO 37.5) median hours in humanities. In the first two years, most humanities are integrated into other course work; most electives are offered as stand-alone classes. 50.0% of schools report only 0-25% of students participating in humanities electives. Presence of a certificate, concentration or arts journal increased likelihood of humanities content but decreased mean hours. Schools with a medical humanities MA had a higher number of required humanities hours. Medical humanities content in undergraduate curriculum is lower than is indicated in the AAMC annual report. Schools with a formal structure have a greater humanities presence in the curriculum and are taken by more students.
Until the 1950's, moral aspects of clinical practice were handled in the USA within the medical profession. Over the last 30 years, these issues have become subjects for public debate, and have changed the public perception of medicine, in four steps. In the 1950's, moral theologians questioned the implications of medical technology at the edges of life. In the late '60s and '70s, these theologians were joined by political activists, whose zeal provoked a counter-reaction from physicians. In the late '70s and early '80s, the debate became largely theoretical; but in the late '80s it is once again "clinical", though respecting the rights of patients, their families, and other nonphysicians to participate in the relevant moral decisions. In part, these four steps reflect the special feature of American social history in the last 30 years; but in part they also had counterparts in Britain and elsewhere. Either way, the monopoly control over the ethics of medical practice exercised by doctors before the 1950s is unlikely to return.
The volume comprises extended abstracts of the papers selected for the presentation at the Third International Andrei Ershov Memorial Conference Perspectives of System Informatics, Akademgorodok (Novosibirsk, Russia), July 6-9, 1999...
Safran, Charles; Bloomrosen, Meryl; Hammond, W Edward; Labkoff, Steven; Markel-Fox, Suzanne; Tang, Paul C; Detmer, Don E; Expert Panel
Secondary use of health data applies personal health information (PHI) for uses outside of direct health care delivery. It includes such activities as analysis, research, quality and safety measurement, public health, payment, provider certification or accreditation, marketing, and other business applications, including strictly commercial activities. Secondary use of health data can enhance health care experiences for individuals, expand knowledge about disease and appropriate treatments, strengthen understanding about effectiveness and efficiency of health care systems, support public health and security goals, and aid businesses in meeting customers' needs. Yet, complex ethical, political, technical, and social issues surround the secondary use of health data. While not new, these issues play increasingly critical and complex roles given current public and private sector activities not only expanding health data volume, but also improving access to data. Lack of coherent policies and standard "good practices" for secondary use of health data impedes efforts to strengthen the U.S. health care system. The nation requires a framework for the secondary use of health data with a robust infrastructure of policies, standards, and best practices. Such a framework can guide and facilitate widespread collection, storage, aggregation, linkage, and transmission of health data. The framework will provide appropriate protections for legitimate secondary use.
Vannier, M W
'Craniofacial imaging informatics' refers to image and related scientific data from the dentomaxillofacial complex, and application of 'informatics techniques' (derived from disciplines such as applied mathematics, computer science and statistics) to understand and organize the information associated with the data. Major trends in information technology determine the progress made in craniofacial imaging and informatics. These trends include industry consolidation, disruptive technologies, Moore's law, electronic atlases and on-line databases. Each of these trends is explained and documented, relative to their influence on craniofacial imaging. Craniofacial imaging is influenced by major trends that affect all medical imaging and related informatics applications. The introduction of cone beam craniofacial computed tomography scanners is an example of a disruptive technology entering the field. An important opportunity lies in the integration of biologic knowledge repositories with craniofacial images. The progress of craniofacial imaging will continue subject to limitations imposed by the underlying technologies, especially imaging informatics. Disruptive technologies will play a major role in the evolution of this field.
Kulikowski, Casimir A; Geissbuhler, Antoine
To provide an editorial introduction to the 2011 IMIA Yearbook of Medical Informatics with an overview of its contents and contributors. A brief overview of the main theme, and an outline of the purposes, contents, format, and acknowledgment of contributions for the 2011 IMIA Yearbook. This 2011 issue of the IMIA Yearbook highlights important developments in the development of Web 3.0 capabilities that are increasing in Health Informatics, impacting the activities in research, education and practice in this interdisciplinary field. There has been steady progress towards introducing semantics into informatics systems through more sophisticated representations of knowledge in their underlying information. Health Informatics 3.0 capabilities are identified from the recent literature, illustrated by selected papers published during the past 12 months, and articles reported by IMIA Working Groups. Surveys of the main research sub-fields in biomedical informatics in the Yearbook provide an overview of progress and current challenges across the spectrum of the discipline, focusing on Web 3.0 challenges and opportunities.
Dong Xu; Alexandrea G. Ham; Rickey D. Tivis; Matthew L. Caylor; Aoxiang Tao; Steve T. Flynn; Peter J. Economen; Hung K. Dang; Royal W. Johnson; Vaughn L. Culbertson
In 2009 the U.S. Food and Drug Administration (FDA) placed a black box warning on metoclopramide (MCP) due to the increased risks and prevalence of tardive dyskinesia (TD). In this study, we developed a multi-step biomedical informatics screening (MSBIS) approach leveraging publicly available bioactivity and drug safety data to identify concomitant drugs that mitigate the risks of MCP-induced TD. MSBIS includes (1) TargetSearch (http://dxulab.org/software) bioinformatics scoring for drug anti...
Athavale, A V; Zodpey, Sanjay P
Public health informatics is emerging as a new and distinct specialty area in the global scenario within the broader discipline of health informatics. The potential role of informatics in reducing health disparities in underserved populations has been identified by a number of reports from all over the world. The article discusses the scope, the limitations, and future perspective of this novice discipline in context to India. It also highlights information and technology related tools namely Geographical Information Systems, Telemedicine and Electronic Medical Record/Electronic Health Record. India needs to leverage its "technology" oriented growth until now (e.g., few satellite-based telemedicine projects, etc.) simultaneously toward development of "information"-based public health informatics systems in future. Under the rapidly evolving scenario of global public health, the future of the public health governance and population health in India would depend upon building and integrating the comprehensive and responsive domain of public health informatics.
Ramapriyan, H. K.
Over the last 10-15 years, significant advances have been made in information management, there are an increasing number of individuals entering the field of information management as it applies to Geoscience and Remote Sensing data, and the field of informatics has come to its own. Informatics is the science and technology of applying computers and computational methods to the systematic analysis, management, interchange, and representation of science data, information, and knowledge. Informatics also includes the use of computers and computational methods to support decision making and applications. Earth Science Informatics (ESI, a.k.a. geoinformatics) is the application of informatics in the Earth science domain. ESI is a rapidly developing discipline integrating computer science, information science, and Earth science. Major national and international research and infrastructure projects in ESI have been carried out or are on-going. Notable among these are: the Global Earth Observation System of Systems (GEOSS), the European Commissions INSPIRE, the U.S. NSDI and Geospatial One-Stop, the NASA EOSDIS, and the NSF DataONE, EarthCube and Cyberinfrastructure for Geoinformatics. More than 18 departments and agencies in the U.S. federal government have been active in Earth science informatics. All major space agencies in the world, have been involved in ESI research and application activities. In the United States, the Federation of Earth Science Information Partners (ESIP), whose membership includes over 180 organizations (government, academic and commercial) dedicated to managing, delivering and applying Earth science data, has been working on many ESI topics since 1998. The Committee on Earth Observation Satellites (CEOS)s Working Group on Information Systems and Services (WGISS) has been actively coordinating the ESI activities among the space agencies.The talk will present an overview of current efforts in ESI, the role members of IEEE GRSS play, and discuss
Swaminathan, Rajeswari; Huang, Yungui; Astbury, Caroline; Fitzgerald-Butt, Sara; Miller, Katherine; Cole, Justin; Bartlett, Christopher; Lin, Simon
The increased adoption of clinical whole exome sequencing (WES) has improved the diagnostic yield for patients with complex genetic conditions. However, the informatics practice for handling information contained in whole exome reports is still in its infancy, as evidenced by the lack of a common vocabulary within clinical sequencing reports generated across genetic laboratories. Genetic testing results are mostly transmitted using portable document format, which can make secondary analysis and data extraction challenging. This paper reviews a sample of clinical exome reports generated by Clinical Laboratory Improvement Amendments-certified genetic testing laboratories at tertiary-care facilities to assess and identify common data elements. Like structured radiology reports, which enable faster information retrieval and reuse, structuring genetic information within clinical WES reports would help facilitate integration of genetic information into electronic health records and enable retrospective research on the clinical utility of WES. We identify elements listed as mandatory according to practice guidelines but are currently missing from some of the clinical reports, which might help to organize the data when stored within structured databases. We also highlight elements, such as patient consent, that, although they do not appear within any of the current reports, may help in interpreting some of the information within the reports. Integrating genetic and clinical information would assist the adoption of personalized medicine for improved patient care and outcomes. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: email@example.com.
This project examines the oral accounts of former slaves, as recorded in the WPA narratives in the 1930s, to study the development of African American medical culture in the Antebellum South. Through an examination of these transcribed memories, my research investigates how African American praxes with medicinal flora, healing techniques, and spiritual harmony, reflected their ethnomedical and cosmological ideologies. The duality of these ideologies represents an African American medical iden...
The RAS Informatics lab group develops tools to track and analyze “big data” from the RAS Initiative, as well as analyzes data from external projects. By integrating internal and external data, this group helps improve understanding of RAS-driven cancers.
Blerot, J.F.; Kschwendt, H.
Open systems and standards in a multi product environment are the EURATOM guidelines. Consequently, the OSI model, UNIX (POSIX) and X/OPEN specifications determine the EURATOM informatic strategy. The major objectives are the development of secured telecommunications, the migration to open systems and the integration of data processing from measurements in the plants to accountancy the headquarters
Lehmann, C U; Gundlapalli, A V
In 1962, Methods of Information in Medicine ( MIM ) began to publish papers on the methodology and scientific fundamentals of organizing, representing, and analyzing data, information, and knowledge in biomedicine and health care. Considered a companion journal, Applied Clinical Informatics ( ACI ) was launched in 2009 with a mission to establish a platform that allows sharing of knowledge between clinical medicine and health IT specialists as well as to bridge gaps between visionary design and successful and pragmatic deployment of clinical information systems. Both journals are official journals of the International Medical Informatics Association. As a follow-up to prior work, we set out to explore congruencies and interdependencies in publications of ACI and MIM. The objectives were to describe the major topics discussed in articles published in ACI in 2014 and to determine if there was evidence that theory in 2014 MIM publications was informed by practice described in ACI publications in any year. We also set out to describe lessons learned in the context of bridging informatics practice and theory and offer opinions on how ACI editorial policies could evolve to foster and improve such bridging. We conducted a retrospective observational study and reviewed all articles published in ACI during the calendar year 2014 (Volume 5) for their main theme, conclusions, and key words. We then reviewed the citations of all MIM papers from 2014 to determine if there were references to ACI articles from any year. Lessons learned in the context of bridging informatics practice and theory and opinions on ACI editorial policies were developed by consensus among the two authors. A total of 70 articles were published in ACI in 2014. Clinical decision support, clinical documentation, usability, Meaningful Use, health information exchange, patient portals, and clinical research informatics emerged as major themes. Only one MIM article from 2014 cited an ACI article. There
Full Text Available Abstract Biomedical informatics involves a core set of methodologies that can provide a foundation for crossing the "translational barriers" associated with translational medicine. To this end, the fundamental aspects of biomedical informatics (e.g., bioinformatics, imaging informatics, clinical informatics, and public health informatics may be essential in helping improve the ability to bring basic research findings to the bedside, evaluate the efficacy of interventions across communities, and enable the assessment of the eventual impact of translational medicine innovations on health policies. Here, a brief description is provided for a selection of key biomedical informatics topics (Decision Support, Natural Language Processing, Standards, Information Retrieval, and Electronic Health Records and their relevance to translational medicine. Based on contributions and advancements in each of these topic areas, the article proposes that biomedical informatics practitioners ("biomedical informaticians" can be essential members of translational medicine teams.
"MedTRIS" (Medical Triage and Registration Informatics System): A Web-based Client Server System for the Registration of Patients Being Treated in First Aid Posts at Public Events and Mass Gatherings.
Gogaert, Stefan; Vande Veegaete, Axel; Scholliers, Annelies; Vandekerckhove, Philippe
First aid (FA) services are provisioned on-site as a preventive measure at most public events. In Flanders, Belgium, the Belgian Red Cross-Flanders (BRCF) is the major provider of these FA services with volunteers being deployed at approximately 10,000 public events annually. The BRCF has systematically registered information on the patients being treated in FA posts at major events and mass gatherings during the last 10 years. This information has been collected in a web-based client server system called "MedTRIS" (Medical Triage and Registration Informatics System). MedTRIS contains data on more than 200,000 patients at 335 mass events. This report describes the MedTRIS architecture, the data collected, and how the system operates in the field. This database consolidates different types of information with regards to FA interventions in a standardized way for a variety of public events. MedTRIS allows close monitoring in "real time" of the situation at mass gatherings and immediate intervention, when necessary; allows more accurate prediction of resources needed; allows to validate conceptual and predictive models for medical resources at (mass) public events; and can contribute to the definition of a standardized minimum data set (MDS) for mass-gathering health research and evaluation. Gogaert S , Vande veegaete A , Scholliers A , Vandekerckhove P . "MedTRIS" (Medical Triage and Registration Informatics System): a web-based client server system for the registration of patients being treated in first aid posts at public events and mass gatherings. Prehosp Disaster Med. 2016;31(5):557-562.
Summary Objective This paper presents the development of medical informatics education during the years from the establishment of the International Medical Informatics Association (IMIA) until today. Method A search in the literature was performed using search engines and appropriate keywords as well as a manual selection of papers. The search covered English language papers and was limited to search on papers title and abstract only. Results The aggregated papers were analyzed on the basis of the subject area, origin, time span, and curriculum development, and conclusions were drawn. Conclusions From the results, it is evident that IMIA has played a major role in comparing and integrating the Biomedical and Health Informatics educational efforts across the different levels of education and the regional distribution of educators and institutions. A large selection of references is presented facilitating future work on the field of education in biomedical and health informatics. PMID:27488405
Baker, Robert B; Washington, Harriet A; Olakanmi, Ololade; Savitt, Todd L; Jacobs, Elizabeth A; Hoover, Eddie; Wynia, Matthew K; Blanchard, Janice; Boulware, L Ebony; Braddock, Clarence; Corbie-Smith, Giselle; Crawley, LaVera; LaVeist, Thomas A; Maxey, Randall; Mills, Charles; Moseley, Kathryn L; Williams, David R
An independent panel of experts, convened by the American Medical Association (AMA) Institute for Ethics, analyzed the roots of the racial divide within American medical organizations. In this, the first of a 2-part report, we describe 2 watershed moments that helped institutionalize the racial divide. The first occurred in the 1870s, when 2 medical societies from Washington, DC, sent rival delegations to the AMA's national meetings: an all-white delegation from a medical society that the US courts and Congress had formally censured for discriminating against black physicians; and an integrated delegation from a medical society led by physicians from Howard University. Through parliamentary maneuvers and variable enforcement of credentialing standards, the integrated delegation was twice excluded from the AMA's meetings, while the all-white society's delegations were admitted. AMA leaders then voted to devolve the power to select delegates to state societies, thereby accepting segregation in constituent societies and forcing African American physicians to create their own, separate organizations. A second watershed involved AMA-promoted educational reforms, including the 1910 Flexner report. Straightforwardly applied, the report's population-based criterion for determining the need for phySicians would have recommended increased training of African American physicians to serve the approximately 9 million African Americans in the segregated south. Instead, the report recommended closing all but 2 African American medical schools, helping to cement in place an African American educational system that was separate, unequal, and destined to be insufficient to the needs of African Americans nationwide.
This volume presents the proceedings of the International Conference on Health Informatics (ICHI). The conference was a new special topic conference initiative by the International Federation of Medical and Biological Engineering (IFMBE), held in Vilamoura, Portugal on 7-9 November, 2013. The main theme of the ICHI2013 was “Integrating Information and Communication Technologies with Biomedicine for Global Health”. The proceedings offer a unique forum to examine enabling technologies of sensors, devices and systems that optimize the acquisition, transmission, processing, storage, retrieval of biomedical and health information as well as to report novel clinical applications of health information systems and the deployment of m-Health, e-Health, u-Health, p-Health and Telemedicine.
Bean, Meghan G.; Focella, Elizabeth S.; Covarrubias, Rebecca; Stone, Jeff; Moskowitz, Gordon B.; Badger, Terry A.
Objective Hispanic Americans and American Indians face significant health disparities compared with White Americans. Research suggests that stereotyping of minority patients by members of the medical community is an important antecedent of race and ethnicity-based health disparities. This work has primarily focused on physicians’ perceptions, however, and little research has examined the stereotypes healthcare personnel associate with Hispanic and American Indian patients. The present study assesses: 1) the health-related stereotypes both nursing and medical students hold about Hispanic and American Indian patients, and 2) nursing and medical students’ motivation to treat Hispanic and American Indian patients in an unbiased manner. Design Participants completed a questionnaire assessing their awareness of stereotypes that healthcare professionals associate with Hispanic and American Indian patients then completed measures of their motivation to treat Hispanics and American Indians in an unbiased manner. Results Despite being highly motivated to treat Hispanic and American Indian individuals fairly, the majority of participants reported awareness of stereotypes associating these patient groups with noncompliance, risky health behavior, and difficulty understanding and/or communicating health-related information. Conclusion This research provides direct evidence for negative health-related stereotypes associated with two understudied minority patient groups—Hispanics and American Indians—among both nursing and medical personnel. PMID:26504671
This book provides a broad overview of the topic Bioinformatics (medical informatics + biological information) with a focus on data, information and knowledge. From data acquisition and storage to visualization, privacy, regulatory, and other practical and theoretical topics, the author touches on several fundamental aspects of the innovative interface between the medical and computational domains that form biomedical informatics. Each chapter starts by providing a useful inventory of definitions and commonly used acronyms for each topic, and throughout the text, the reader finds several real-world examples, methodologies, and ideas that complement the technical and theoretical background. Also at the beginning of each chapter a new section called "key problems", has been added, where the author discusses possible traps and unsolvable or major problems. This new edition includes new sections at the end of each chapter, called "future outlook and research avenues," providing pointers to future challenges.
involves careful consideration of both human and organizational factors. This book presents the proceedings of the Context Sensitive Health Informatics (CSHI) conference, held in Copenhagen, Denmark, in August 2013. The theme of this year’s conference is human and sociotechnical approaches. The Human...... different healthcare contexts. Healthcare organizations, health policy makers and regulatory bodies globally are starting to acknowledge this essential role of human and organizational factors for safe and effective health information technology. This book will be of interest to all those involved......Healthcare information technologies are now routinely deployed in a variety of healthcare contexts. These contexts differ widely, but the smooth integration of IT systems is crucial, so the design, implementation, and evaluation of safe, effective, efficient and easy to adopt health informatics...
Kusonmano, Kanthida; Vongsangnak, Wanwipa; Chumnanpuen, Pramote
Metabolome profiling of biological systems has the powerful ability to provide the biological understanding of their metabolic functional states responding to the environmental factors or other perturbations. Tons of accumulative metabolomics data have thus been established since pre-metabolomics era. This is directly influenced by the high-throughput analytical techniques, especially mass spectrometry (MS)- and nuclear magnetic resonance (NMR)-based techniques. Continuously, the significant numbers of informatics techniques for data processing, statistical analysis, and data mining have been developed. The following tools and databases are advanced for the metabolomics society which provide the useful metabolomics information, e.g., the chemical structures, mass spectrum patterns for peak identification, metabolite profiles, biological functions, dynamic metabolite changes, and biochemical transformations of thousands of small molecules. In this chapter, we aim to introduce overall metabolomics studies from pre- to post-metabolomics era and their impact on society. Directing on post-metabolomics era, we provide a conceptual framework of informatics techniques for metabolomics and show useful examples of techniques, tools, and databases for metabolomics data analysis starting from preprocessing toward functional interpretation. Throughout the framework of informatics techniques for metabolomics provided, it can be further used as a scaffold for translational biomedical research which can thus lead to reveal new metabolite biomarkers, potential metabolic targets, or key metabolic pathways for future disease therapy.
Kohli, Marc; Dreyer, Keith J; Geis, J Raymond
Imaging 3.0 is a radiology community initiative to empower radiologists to create and demonstrate value for their patients, referring physicians, and health systems. In image-guided health care, radiologists contribute to the entire health care process, well before and after the actual examination, and out to the point at which they guide clinical decisions and affect patient outcome. Because imaging is so pervasive, radiologists who adopt Imaging 3.0 concepts in their practice can help their health care systems provide consistently high-quality care at reduced cost. By doing this, radiologists become more valuable in the new health care setting. The authors describe how informatics is critical to embracing Imaging 3.0 and present a scorecard that can be used to gauge a radiology group's informatics resources and capabilities. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Monique S. Roy
Conclusions. The development of hypertension in African-Americans living with type 1 diabetes appears to be multifactorial and includes both medical (overt proteinuria as well as psychological (high hostility risk factors.
PROF. BARTH EKWEME
179 .... how organizations can utilize IT to progress their strategic goal from ... Clinical informatics, Veterinary informatics, Dental informatics ... In the late 1990s, the Finnish/Nigerian research ..... International Journal of Nursing &. Midwifery, 5, (5): ...
Domino, George; Takahashi, Yoshitomo
Administered Suicide Opinion Questionnaire to 100 medical students from Japan and 100 medical students from the United States (80 percent males, 20 percent females). Found significant differences on Right to Die, Normality, and Aggression scales between Japanese and U.S. students, and significant gender differences on Religion and Impulsivity…
Despite recommendations by medical reformers that medical sociology be included in the curriculum, there is currently little evidence of a far-reaching integration of sociological perspectives in American medical education. Yet, support for the relevance of sociological knowledge has since the late 1960s helped to diffuse external pressures for change in health care and medical education. As a symbol of the communitarian commitment of the medical profession, claims in favor of the incorporation of sociological perspectives have thus occasionally, and largely unintentionally, served the public relations interests of biomedicine. However, the more recent interest in medical ethics has to some degree transformed medicine's educational agenda and the definition of medical 'human values'. Whereas the rhetorical expropriation of medical sociology primarily has concerned medicine's responsibility vis-à-vis society as a whole, the new medical ethics education signifies a return to a more individualistically oriented medical morality.
Xu, Dong; Ham, Alexandrea G; Tivis, Rickey D; Caylor, Matthew L; Tao, Aoxiang; Flynn, Steve T; Economen, Peter J; Dang, Hung K; Johnson, Royal W; Culbertson, Vaughn L
In 2009 the U.S. Food and Drug Administration (FDA) placed a black box warning on metoclopramide (MCP) due to the increased risks and prevalence of tardive dyskinesia (TD). In this study, we developed a multi-step biomedical informatics screening (MSBIS) approach leveraging publicly available bioactivity and drug safety data to identify concomitant drugs that mitigate the risks of MCP-induced TD. MSBIS includes (1) TargetSearch (http://dxulab.org/software) bioinformatics scoring for drug anticholinergic activity using CHEMBL bioactivity data; (2) unadjusted odds ratio (UOR) scoring for indications of TD-mitigating effects using the FDA Adverse Event Reporting System (FAERS); (3) adjusted odds ratio (AOR) re-scoring by removing the effect of cofounding factors (age, gender, reporting year); (4) logistic regression (LR) coefficient scoring for confirming the best TD-mitigating drug candidates. Drugs with increasing TD protective potential and statistical significance were obtained at each screening step. Fentanyl is identified as the most promising drug against MCP-induced TD (coefficient: -2.68; p-valueTD after fentanyl-induced general anesthesia. Loperamide is identified as a potent mitigating drug against a broader range of drug-induced movement disorders through pharmacokinetic modifications. Using drug-induced TD as an example, we demonstrated that MSBIS is an efficient in silico tool for unknown drug-drug interaction detection, drug repurposing, and combination therapy design. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.
Full Text Available Automation and emerging information technologies are being adopted by cytology laboratories to augment Pap test screening and improve diagnostic accuracy. As a result, informatics, the application of computers and information systems to information management, has become essential for the successful operation of the cytopathology laboratory. This review describes how laboratory information management systems can be used to achieve an automated and seamless workflow process. The utilization of software, electronic databases and spreadsheets to perform necessary quality control measures are discussed, as well as a Lean production system and Six Sigma approach, to reduce errors in the cytopathology laboratory.
Kuziemsky, Craig; Nøhr, Christian; Aarts, Jos
Context is a key consideration when designing and evaluating health information technology (HIT) and cannot be overstated. Unintended consequences are common post HIT implementation and even well designed technology may not achieve desired outcomes because of contextual issues. While context should...... be considered in the design and evaluation of health information systems (HISs) there is a shortcoming of empirical research on contextual aspects of HIT. This conference integrates the sociotechnical and Human-Centered-Design (HCD) approaches and showcases current research on context sensitive health...... informatics. The papers and presentations outlines theories and models for studying contextual issues and insights on how we can better design HIT to accommodate different healthcare contexts....
Many health care providers believe that the autopsy is no longer relevant in high-technology medicine era. This has fueled a decline in the hospital autopsy rate. Although it seems that advanced diagnostic tests answer all clinical questions, studies repeatedly demonstrate that an autopsy uncovers as many undiagnosed conditions today as in the past. The forensic autopsy rate has also declined, although not as precipitously. Pathologists are still performing a nineteenth century autopsy procedure that remains essentially unchanged. Informatics offers several potential answers that will evolve the low-tech autopsy into the high-tech autopsy. Copyright © 2015 Elsevier Inc. All rights reserved.
Full Text Available Based on international standardization and power utility practices, this paper presents a preliminary and systematic study on the field of energy informatics and analyzes boundary expansion of information and energy system, and the convergence of energy system and ICT. A comprehensive introduction of the fundamentals and standardization of energy informatics is provided, and several key open issues are identified.
Southerland, William M; Swamidass, S Joshua; Payne, Philip R O; Wiley, Laura; Williams-DeVane, ClarLynda
The Diversity and Disparity in Biomedical Informatics (DDBI) workshop will be focused on complementary and critical issues concerned with enhancing diversity in the informatics workforce as well as diversity in patient cohorts. According to the National Institute of Minority Health and Health Disparities (NIMHD) at the NIH, diversity refers to the inclusion of the following traditionally underrepresented groups: African Americans/Blacks, Asians (>30 countries), American Indian or Alaska Native, Native Hawaiian or Other Pacific Islander, Latino or Hispanic (20 countries). Gender, culture, and socioeconomic status are also important dimensions of diversity, which may define some underrepresented groups. The under-representation of specific groups in both the biomedical informatics workforce as well as in the patient-derived data that is being used for research purposes has contributed to an ongoing disparity; these groups have not experienced equity in contributing to or benefiting from advancements in informatics research. This workshop will highlight innovative efforts to increase the pool of minority informaticians and discuss examples of informatics research that addresses the health concerns that impact minority populations. This workshop topics will provide insight into overcoming pipeline issues in the development of minority informaticians while emphasizing the importance of minority participation in health related research. The DDBI workshop will occur in two parts. Part I will discuss specific minority health & health disparities research topics and Part II will cover discussions related to overcoming pipeline issues in the training of minority informaticians.
Medical systems in the USA such as EBM., DRG., Informed Consent and Second Opinion have already been introduced into the Japanese medical system. However, some of these systems have met resistance from a part of the population due to the differences of social structures, morals and customs between the two countries. Briefly, I described the medical education and licensure, the private practice and "open hospital system" of the USA. The following 4 topics which drew great interest in Japan will be discussed. 1) CEREBRAL DEATH AND BIOETHICS: Cerebral death has been restrictively accepted as human death since the 1980's only in terms of terminal cares in clinical medicine. The rather simplified current neurological criteria for death are approved in the USA. In order for an organ transplant to take place, a potential donor must be diagnosed as brain dead. However, Japanese society has not accepted the concept of cerebral death completely because of an accident in the 1960's where an organ was improperly removed when the donor who was not in the state of brain death. Recently, more people in Japan are showing interest in Dignity and Euthanasia from the point of view of "Right to die". 2) MALPRACTICE AND LITIGATION: "To err is human" was introduced by the Institute of Medicine for Risk Management. Accidental deaths of patients under medical care ranks No.8 in total number of deaths in the USA. There are 100,000 malpractice cases in the "Lawsuit Society" of America, which is 100 times that of Japan. Furthermore, the legal fees and insurance premiums are extremely high in the US as opposed to very low in Japan. 3) HEALTH CARE INSURANCE: To reduce medical costs, the insurance companies introduced "Competitive Managed Care" which resulted in the formation of "Health Maintenance Organizations" (HMO). Furthermore, when you compare the two countries in respect to those who have health insurance, 44 million in the USA carry no health insurance, whereas in Japan, the government
Longenecker, Herbert E., Jr.; Campbell, S. Matt; Landry, Jeffrey P.; Pardue, Harold; Daigle, Roy J.
In addition to being a relevant program for health information technology workers, a recently proposed Health Informatics program was designed with additional objectives in mind: that the program is compatible with the IS 2010 Model Curriculum and that it satisfies the International Medical Informatics Association recommendation for undergraduate…
Full Text Available In 2009 the U.S. Food and Drug Administration (FDA placed a black box warning on metoclopramide (MCP due to the increased risks and prevalence of tardive dyskinesia (TD. In this study, we developed a multi-step biomedical informatics screening (MSBIS approach leveraging publicly available bioactivity and drug safety data to identify concomitant drugs that mitigate the risks of MCP-induced TD. MSBIS includes (1 TargetSearch (http://dxulab.org/software bioinformatics scoring for drug anticholinergic activity using CHEMBL bioactivity data; (2 unadjusted odds ratio (UOR scoring for indications of TD-mitigating effects using the FDA Adverse Event Reporting System (FAERS; (3 adjusted odds ratio (AOR re-scoring by removing the effect of cofounding factors (age, gender, reporting year; (4 logistic regression (LR coefficient scoring for confirming the best TD-mitigating drug candidates. Drugs with increasing TD protective potential and statistical significance were obtained at each screening step. Fentanyl is identified as the most promising drug against MCP-induced TD (coefficient: −2.68; p-value < 0.01. The discovery is supported by clinical reports that patients fully recovered from MCP-induced TD after fentanyl-induced general anesthesia. Loperamide is identified as a potent mitigating drug against a broader range of drug-induced movement disorders through pharmacokinetic modifications. Using drug-induced TD as an example, we demonstrated that MSBIS is an efficient in silico tool for unknown drug-drug interaction detection, drug repurposing, and combination therapy design.
Blash, Anthony; Saltsman, Connie L; Steil, Condit
Upon completion of their post-graduate training, pharmacy informatics residents need to be prepared to interact with clinical and technology experts in the new healthcare environment. This study describes pharmacy informatics residency programs within the United States. Preliminary information for all pharmacy informatics residency programs was accessed from program webpages. An email was sent out to programs asking them to respond to a six-item questionnaire. This questionnaire was designed to elicit information on attributes of the program, behaviors of the preceptors and residents, and attitudes of the residency directors. Of 22 pharmacy informatics residencies identified, nineteen (86%) participated. Twenty (91%) were second post-graduate year (PGY2) residencies. Ten (45%) were accredited by the American Society of Health-System Pharmacists (ASHP), while eight (36%) were candidates for accreditation. Hospital (17/22, 77%) and administrative offices (3/22, 14%) were the predominant training sites for pharmacy informatics residents. Large institutions were the predominant training environment for the pharmacy informatics resident, with 19 of 22 (86%) institutions reporting a licensed bed count of 500 or more. The median (range) number of informatics preceptors at a site was six to eight. Regarding barriers to pharmacy informatics residency education, residency directors reported that residents did not feel prepared based on the limited availability of curricular offerings. In the United States, relatively few residencies are explicitly focused on pharmacy informatics. Most of these are accredited and hospital affiliated, especially with large institutions (>500 beds). Copyright © 2017 Elsevier Inc. All rights reserved.
The start of Latin America's love story with fungi may be placed in pre-Hispanic times when the use of fungi in both ritual ceremonies and daily life were common to the native civilizations. But the medical mycology discipline in Latin America started at the end of the 19th Century. At that time, scholars such as A. Posadas, R. Seeber, A. Lutz and P. Almeida, discovered agents of fungal diseases, the study of which has influenced the regional research ever since. Heirs to them are the researchers that today thrive in regional Universities and Research Institutes. Two current initiatives improve cooperation among Latin American medical mycologists. First, the periodical organization of International Paracoccidioidomycosis Meetings (seven so far, from 1979 to 1999); second, the creation of the Latin American Association for Mycology in 1991 (three Congresses, from 1993 to 1999). Latin American publications have increased in international specialized journals such as that from our Society (ISHAM) (from 8% in 1967 to 19% in 1999), and the Iberoamerican Journal of Mycology (Revista Iberoamericana de Micologia; > 40% from 1997 to 1999). In addition, Latin American participation at ISHAM International Congresses has risen from 6.9% in 1975 to 21.3% in 1997, and 43.2% at the 14th ISHAM Congress, held for the first time in a Latin American country, Argentina. A significant contribution of women to the scientific establishment of Latin American medical mycology (e.g., 45% of Latin American papers vs. 18% of other regions published in Journal of Medical and Veterinary Mycology in 1987, had women as authors or coauthors) suggests a better academic consideration of Latin American women against their counterparts in the developed world. Taken together, all these figures reflect the enthusiasm of our Latin American colleagues in the field, despite the difficulties that afflict our region, and affect our work.
Kulikowski, Casimir A.; Bakken, Suzanne; de Lusignan, Simon; Kimura, Michio; Koch, Sabine; Mantas, John; Maojo, Victor; Marschollek, Michael; Martin-Sanchez, Fernando; Moen, Anne; Park, Hyeoun-Ae; Sarkar, Indra Neil; Leong, Tze Yun; McCray, Alexa T.
Summary Background Medical informatics, or biomedical and health informatics (BMHI), has become an established scientific discipline. In all such disciplines there is a certain inertia to persist in focusing on well-established research areas and to hold on to well-known research methodologies rather than adopting new ones, which may be more appropriate. Objectives To search for answers to the following questions: What are research fields in informatics, which are not being currently adequately addressed, and which methodological approaches might be insufficiently used? Do we know about reasons? What could be consequences of change for research and for education? Methods Outstanding informatics scientists were invited to three panel sessions on this topic in leading international conferences (MIE 2015, Medinfo 2015, HEC 2016) in order to get their answers to these questions. Results A variety of themes emerged in the set of answers provided by the panellists. Some panellists took the theoretical foundations of the field for granted, while several questioned whether the field was actually grounded in a strong theoretical foundation. Panellists proposed a range of suggestions for new or improved approaches, methodologies, and techniques to enhance the BMHI research agenda. Conclusions The field of BMHI is on the one hand maturing as an academic community and intellectual endeavour. On the other hand vendor-supplied solutions may be too readily and uncritically accepted in health care practice. There is a high chance that BMHI will continue to flourish as an important discipline; its innovative interventions might then reach the original objectives of advancing science and improving health care outcomes. PMID:28119991
Hassanien, Aboul; El-Bendary, Nashwa; Dey, Nilanjan
The conference topics address different theoretical and practical aspects, and implementing solutions for intelligent systems and informatics disciplines including bioinformatics, computer science, medical informatics, biology, social studies, as well as robotics research. The conference also discuss and present solutions to the cloud computing and big data mining which are considered hot research topics. The conference papers discussed different topics – techniques, models, methods, architectures, as well as multi aspect, domain-specific, and new solutions for the above disciplines. The accepted papers have been grouped into five parts: Part I—Intelligent Systems and Informatics, addressing topics including, but not limited to, medical application, predicting student performance, action classification, and detection of dead stained microscopic cells, optical character recognition, plant identification, rehabilitation of disabled people. Part II—Hybrid Intelligent Systems, addressing topics including, b...
Full Text Available The medical humanities, a cross-disciplinary field of practice and research that includes medicine, literature, art, history, philosophy, and sociology, is being increasingly incorporated into medical school curricula internationally. Medical humanities courses in Writing, Literature, Medical Ethics and History can teach physicians-in-training communication skills, doctor-patient relations, and medical ethics, as well as empathy and cross-cultural understanding. In addition to providing educational breadth and variety, the medical humanities can also play a practical role in teaching critical/analytical skills. These skills are utilized in differential diagnosis and problem-based learning, as well as in developing written and oral communications. Communication skills are a required medical competency for passing medical board exams in the U.S., Canada, the UK and elsewhere. The medical library is an integral part of medical humanities training efforts. This contribution provides a case study of the Distributed eLibrary at the Weill Cornell Medical College in Qatar in Doha, and its collaboration with the Writing Program in the Premedical Program to teach and develop the medical humanities. Programs and initiatives of the DeLib library include: developing an information literacy course, course guides for specific courses, the 100 Classic Books Project, collection development of ‘doctors’ stories’ related to the practice of medicine (including medically-oriented movies and TV programs, and workshops to teach the analytical and critical thinking skills that form the basis of humanistic approaches to knowledge. This paper outlines a ‘best practices’ approach to developing the medical humanities in collaboration among the medical library, faculty and administrative stakeholders.
Birch, Sally; Magid, Amani; Weber, Alan
The medical humanities, a cross-disciplinary field of practice and research that includes medicine, literature, art, history, philosophy, and sociology, is being increasingly incorporated into medical school curricula internationally. Medical humanities courses in Writing, Literature, Medical Ethics and History can teach physicians-in-training communication skills, doctor-patient relations, and medical ethics, as well as empathy and cross-cultural understanding. In addition to providing educational breadth and variety, the medical humanities can also play a practical role in teaching critical/analytical skills. These skills are utilized in differential diagnosis and problem-based learning, as well as in developing written and oral communications. Communication skills are a required medical competency for passing medical board exams in the U.S., Canada, the UK and elsewhere. The medical library is an integral part of medical humanities training efforts. This contribution provides a case study of the Distributed eLibrary at the Weill Cornell Medical College in Qatar in Doha, and its collaboration with the Writing Program in the Premedical Program to teach and develop the medical humanities. Programs and initiatives of the DeLib library include: developing an information literacy course, course guides for specific courses, the 100 Classic Books Project, collection development of 'doctors' stories' related to the practice of medicine (including medically-oriented movies and TV programs), and workshops to teach the analytical and critical thinking skills that form the basis of humanistic approaches to knowledge. This paper outlines a 'best practices' approach to developing the medical humanities in collaboration among the medical library, faculty and administrative stakeholders.
Mills, Michael D.
The American Association of Medical Dosimetrists (AAMD) designed and directed 2 surveys of the AAMD membership. The first was in 2011 and the second in 2014. There were a number of questions common to both surveys, and this article seeks to evaluate these common questions to determine trends among the professional membership of the AAMD. It is demonstrated that the observed trends are consistent with the goals and objectives established by the leadership of the AAMD and the Medical Dosimetry Certification Board (MDCB) for the medical dosimetry community. In addition, certain challenges and opportunities involving the scope of practice for the medical dosimetry profession are discussed
Mills, Michael D., E-mail: firstname.lastname@example.org
The American Association of Medical Dosimetrists (AAMD) designed and directed 2 surveys of the AAMD membership. The first was in 2011 and the second in 2014. There were a number of questions common to both surveys, and this article seeks to evaluate these common questions to determine trends among the professional membership of the AAMD. It is demonstrated that the observed trends are consistent with the goals and objectives established by the leadership of the AAMD and the Medical Dosimetry Certification Board (MDCB) for the medical dosimetry community. In addition, certain challenges and opportunities involving the scope of practice for the medical dosimetry profession are discussed.
van Mulligen, Erik M; Cases, Montserrat; Hettne, Kristina; Molero, Eva; Weeber, Marc; Robertson, Kevin A; Oliva, Baldomero; de la Calle, Guillermo; Maojo, Victor
The European INFOBIOMED Network of Excellence recognized that a successful education program in biomedical informatics should include not only traditional teaching activities in the basic sciences but also the development of skills for working in multidisciplinary teams. A carefully developed 3-year training program for biomedical informatics students addressed these educational aspects through the following four activities: (1) an internet course database containing an overview of all Medical Informatics and BioInformatics courses, (2) a BioMedical Informatics Summer School, (3) a mobility program based on a 'brokerage service' which published demands and offers, including funding for research exchange projects, and (4) training challenges aimed at the development of multi-disciplinary skills. This paper focuses on experiences gained in the development of novel educational activities addressing work in multidisciplinary teams. The training challenges described here were evaluated by asking participants to fill out forms with Likert scale based questions. For the mobility program a needs assessment was carried out. The mobility program supported 20 exchanges which fostered new BMI research, resulted in a number of peer-reviewed publications and demonstrated the feasibility of this multidisciplinary BMI approach within the European Union. Students unanimously indicated that the training challenge experience had contributed to their understanding and appreciation of multidisciplinary teamwork. The training activities undertaken in INFOBIOMED have contributed to a multi-disciplinary BMI approach. It is our hope that this work might provide an impetus for training efforts in Europe, and yield a new generation of biomedical informaticians.
Steckler, Taylor J; Brownlee, Michael J; Urick, Benjamin Y; Farley, Matthew J
Pharmacy informatics involves the customization and application of information technology to improve medication-related processes. It is a critical function given the recent expansion of technology and prevalence of medication use throughout healthcare. Despite the necessity for pharmacy involvement, many pharmacists and student pharmacists are unaware of how to get started in informatics. Ideally, training should start early with student pharmacists being enrolled in introductory courses taught by leaders in the field. Students especially interested in informatics can build upon their classroom experience with postgraduate year two (PGY2) residencies in several informatics-related areas. Additionally, current pharmacists can gather information from national pharmacy organizations and local information technology pharmacists to prepare for projects in the field. These approaches provide opportunities for all pharmacists to expand their knowledge and establish the basis for highly-motivated pharmacists to become experts in informatics. Copyright © 2017 Elsevier Inc. All rights reserved.
Hanna, Matthew G; Pantanowitz, Liron
The practice of cytopathology has dramatically changed due to advances in genomics and information technology. Cytology laboratories have accordingly become increasingly dependent on pathology informatics support to meet the emerging demands of precision medicine. Pathology informatics deals with information technology in the laboratory, and the impact of this technology on workflow processes and staff who interact with these tools. This article covers the critical role that laboratory information systems, electronic medical records, and digital imaging plays in patient-centered personalized medicine. The value of integrated diagnostic reports, clinical decision support, and the use of whole-slide imaging to better evaluate cytology samples destined for molecular testing is discussed. Image analysis that offers more precise and quantitative measurements in cytology is addressed, as well as the role of bioinformatics tools to cope with Big Data from next-generation sequencing. This article also highlights the barriers to the widespread adoption of these disruptive technologies due to regulatory obstacles, limited commercial solutions, poor interoperability, and lack of standardization. Cancer Cytopathol 2017;125(6 suppl):494-501. © 2017 American Cancer Society. © 2017 American Cancer Society.
To provide an overview of the history of electronic health policy and identify significant laws that influence health informatics. US Department of Health and Human Services. The development of health information technology has influenced the process for delivering health care. Public policy and regulations are an important part of health informatics and establish the structure of electronic health systems. Regulatory bodies of the government initiate policies to ease the execution of electronic health record implementation. These same bureaucratic entities regulate the system to protect the rights of the patients and providers. Nurses should have an overall understanding of the system behind health informatics and be able to advocate for change. Nurses can utilize this information to optimize the use of health informatics and campaign for safe, effective, and efficient health information technology. Copyright © 2018 Elsevier Inc. All rights reserved.
Ingram, D; Murphy, J
Previous case reports in this series on Education and Training have looked at specialist courses for postgraduate students seeking an in-depth knowledge of informatics and a career in the field. By contrast, this review describes a project designed to pilot a series of learning opportunities for undergraduate medical students. Although some UK medical colleges have opted to introduce informatics into the curriculum as a discipline in its own right, the Informatics Department at St Bartholomew's Hospital Medical College chose a different approach. When a new curriculum was introduced at St Bartholomew's and at The London Hospital Medical College, the Head of the Informatics Department saw this as an ideal opportunity to explore ways of integrating informatics into the curriculum. The initiatives described in this paper were made possible as a result of an award from the UK government Department of Employment. Money from an Enterprise in Higher Education grant funded a range of programmes, one of which was designed to introduce students to selected aspects of informatics and to demonstrate what is feasible in the undergraduate curriculum. The work carried out over a period of three and a half years was intended to provide the basis for the next phase of curriculum development. However, in the wake of the restructuring which has taken place in London medical colleges, the Informatics Department at what was St Bartholomew's has relocated to University College London Medical School, and is now called The Centre for Health Informatics and Multiprofessional Education (CHIME). University College is designing a new medical curriculum and CHIME is drawing on the experience gained through the Enterprise Project to find the best way to integrate informatics into this curriculum.
Sipes, Carolyn; Hunter, Kathleen; McGonigle, Dee; West, Karen; Hill, Taryn; Hebda, Toni
, given that Health Information Technology Competencies includes all healthcare workers, while the TIGER-based Assessment of Nursing Informatics Competencies and Nursing Informatics Competency Assessment of Level 3 and Level 4 tools and the American Nurses Association Nursing Informatics: Scope and Standards of Practice are nurse specific. No clear cross mapping across these tools and the standards of nursing informatics practice exists. Further examination and review are needed to translate Health Information Technology Competencies as a viable tool for nursing informatics use in the US.
Shultz, S M
This is the biography of a deceased medical journal, the North American Medical and Surgical Journal, born in 1826 in Philadelphia. It was a publication of the Philadelphia Chapter of the Kappa Lambda Society. In the prospectus of the North American Medical and Surgical Journal the promoters observed that a well-conducted journal would achieve the object of elevating the medical profession to its legitimate rank which up to that time had been the recipient of low public opinion. The Journal hoped to inculcate 'a higher standard of excellence not merely in the professional or ministrative but also in the ethical relations and duties of physicians'. After several successful and productive years it passed into history in October 1831, the victim of financial difficulty.
Acharya, U; Dua, Prerna
The book is a unique effort to represent a variety of techniques designed to represent, enhance, and empower multi-disciplinary and multi-institutional machine learning research in healthcare informatics. The book provides a unique compendium of current and emerging machine learning paradigms for healthcare informatics and reflects the diversity, complexity and the depth and breath of this multi-disciplinary area. The integrated, panoramic view of data and machine learning techniques can provide an opportunity for novel clinical insights and discoveries.
Bockwoldt, Denise; Staffileno, Beth A; Coke, Lola; Hamilton, Rebekah; Fogg, Lou; Calvin, Donna; Quinn, Lauretta
African American (AA) adults are disproportionally affected by type 2 diabetes and are diagnosed at an earlier age, but are less adherent to diabetes medications compared with the general population. This qualitative study sought to describe the experiences of taking diabetes medications among midlife AA men and women with type 2 diabetes and to identify factors that influence these experiences. Fifteen AAs completed semistructured interviews. Using the Roy adaptation model, thematic analysis coded for both adaptive and ineffective experiences. Adaptive experiences included self-confidence in one's ability to control diabetes, a belief in the value of diabetes medication, assuming responsibility for one's health, developing a routine for taking medication, and positive relationships with the care team. Ineffective experiences for medication taking included: feeling powerless over diabetes, self-blame, and fear. One's self-concept as a person with diabetes, as well as assuming the role of "medication taker," were prominent themes.
Rubin, Zachary; Blackham, Kristine
This study describes the state of preclinical radiology curricula in North American allopathic, osteopathic, and podiatric medical schools. An online survey of teaching methods, radiology topics, and future plans was developed. The Associations of American Medical Colleges, Colleges of Osteopathic Medicine, and Colleges of Podiatric Medicine listing for all US, Canadian, and Puerto Rican schools was used for contact information for directors of anatomy and/or radiology courses. Letters were sent via e-mail to 198 schools, with a link to the anonymous survey. Of 198 schools, 98 completed the survey (48%). Radiology curricula were integrated with other topics (91%), and taught by anatomists (42%) and radiologists (43%). The majority of time was spent on the topic of anatomy correlation (35%). Time spent teaching general radiology topics in the curriculum, such as physics (3%), modality differences (6%), radiation safety (2%), and contrast use (2%) was limited. Most schools had plans to implement an innovative teaching method in the near future (62%). The major challenges included limits on: time in the curriculum (73%); resources (32%); and radiology faculty participation (30%). A total of 82% reported that their curriculum did not model the suggestions made by the Alliance of Medical Student Educators in Radiology. This survey describes the current state of preclinical radiology teaching: curricula were nonstandard, integrated into other courses, and predominantly used for anatomy correlation. Other important contextual principles of the practice of radiology were seldom taught. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Valdez, Rupa S; Holden, Richard J; Novak, Laurie L; Veinot, Tiffany C
Designing patient-centered consumer health informatics (CHI) applications requires understanding and creating alignment with patients' and their family members' health-related activities, referred to here as 'patient work'. A patient work approach to CHI draws on medical social science and human factors engineering models and simultaneously attends to patients, their family members, activities, and context. A patient work approach extends existing approaches to CHI design that are responsive to patients' biomedical realities and personal skills and behaviors. It focuses on the embeddedness of patients' health management in larger processes and contexts and prioritizes patients' perspectives on illness management. Future research is required to advance (1) theories of patient work, (2) methods for assessing patient work, and (3) techniques for translating knowledge of patient work into CHI application design. Advancing a patient work approach within CHI is integral to developing and deploying consumer-facing technologies that are integrated with patients' everyday lives. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: email@example.com. For numbered affiliations see end of article.
Hilty, Donald M.; Benjamin, Sheldon; Briscoe, Gregory; Hales, Deborah J.; Boland, Robert J.; Luo, John S.; Chan, Carlyle H.; Kennedy, Robert S.; Karlinsky, Harry; Gordon, Daniel B.; Yellowlees, Peter M.; Yager, Joel
Objective: This article provides an overview of how trainees, faculty, and institutions use technology for acquiring knowledge, skills, and attitudes for practicing modern medicine. Method: The authors reviewed the literature on medical education, technology, and change, and identify the key themes and make recommendations for implementing…
Hidaka, Brandon H; Asghar, Anila; Aktipis, C Athena; Nesse, Randolph M; Wolpaw, Terry M; Skursky, Nicole K; Bennett, Katelyn J; Beyrouty, Matthew W; Schwartz, Mark D
Medical and public health scientists are using evolution to devise new strategies to solve major health problems. But based on a 2003 survey, medical curricula may not adequately prepare physicians to evaluate and extend these advances. This study assessed the change in coverage of evolution in North American medical schools since 2003 and identified opportunities for enriching medical education. In 2013, curriculum deans for all North American medical schools were invited to rate curricular coverage and perceived importance of 12 core principles, the extent of anticipated controversy from adding evolution, and the usefulness of 13 teaching resources. Differences between schools were assessed by Pearson's chi-square test, Student's t-test, and Spearman's correlation. Open-ended questions sought insight into perceived barriers and benefits. Despite repeated follow-up, 60 schools (39%) responded to the survey. There was no evidence of sample bias. The three evolutionary principles rated most important were antibiotic resistance, environmental mismatch, and somatic selection in cancer. While importance and coverage of principles were correlated (r = 0.76, P evolutionary principles were covered by 4 to 74% more schools. Nearly half (48%) of responders anticipated igniting controversy at their medical school if they added evolution to their curriculum. The teaching resources ranked most useful were model test questions and answers, case studies, and model curricula for existing courses/rotations. Limited resources (faculty expertise) were cited as the major barrier to adding more evolution, but benefits included a deeper understanding and improved patient care. North American medical schools have increased the evolution content in their curricula over the past decade. However, coverage is not commensurate with importance. At a few medical schools, anticipated controversy impedes teaching more evolution. Efforts to improve evolution education in medical schools
... Updated American Veterinary Medical Association Guidelines for the Euthanasia of Animals: 2013 Edition... for the Euthanasia of Animals: 2013 Edition (Guidelines). The NIH is seeking input from the public on... updated AVMA Guidelines for the Euthanasia of Animals: 2013 Edition must be submitted electronically at...
In WWI, the United States was segregated by custom and law, and the Army obeyed the laws, reducing opportunities for Black medical professionals to serve their country in uniform. This article surveys African-American medical personnel serving in the US Army in World War I. It includes physicians, dentists, veterinarians, and other commissioned officers, as well as medical enlisted men. Overall, despite segregation and associated professional limitations, determined individuals still served with distinction in a variety of roles, opening doors for future advances. Published by Elsevier Inc.
Philip J. Scott
Full Text Available Introduction: The Informatics for Health congress, 24-26 April 2017, in Manchester, UK, brought together the Medical Informatics Europe (MIE conference and the Farr Institute International Conference. This special issue of the Journal of Innovation in Health Informatics contains 113 presentation abstracts and 149 poster abstracts from the congress. Discussion: The twin programmes of “Big Data” and “Digital Health” are not always joined up by coherent policy and investment priorities. Substantial global investment in health IT and data science has led to sound progress but highly variable outcomes. Society needs an approach that brings together the science and the practice of health informatics. The goal is multi-level Learning Health Systems that consume and intelligently act upon both patient data and organizational intervention outcomes. Conclusions: Informatics for Health demonstrated the art of the possible, seen in the breadth and depth of our contributions. We call upon policy makers, research funders and programme leaders to learn from this joined-up approach.
Physicians figured prominently in the resurgence of nuclear weapons activism and cultural awareness that swept the US in the early 1980s. This discussion seeks to place this activism in historical context. It explores the American medical profession's shifting engagement with the issue of nuclear war. Attention is focused on the period 1945 to 1954, with a brief evaluation of the period 1954 to 1963, the years to which the activism of the 1980s may be traced. Radiation studies are reviewed including Hiroshima and Nagasaki survivors. Radiological studies were begun within days of Japan's surrender. The delayed effects of radiation exposure on some 14,000 persons in Hiroshima and Nagasaki include hemorrhage, leukocyte destruction, bone marrow damage, anemia, sterility, and the suppression of menstruation. In contrast, the American medical profession in the late 1940s focused much attention on the atom's potential medical benefits, especially the diagnostic and treatment value of radioisotopes. 90 references
Park, R J
'Playing Hurt/Playing Tough', a dominant ideology in today's football (soccer, rugby, American 'gridiron'), is by no means new. Many books, monographs, and articles have examined the historical development of these games, but the attention given to them in the medical press during the late 1800s/early 1900s has been overlooked. The Lancet, Journal of the American Medical Association, and other turn-of-the-century medical publications regularly included accounts and descriptions of injuries and deaths. More telling were the many editorials in which physicians in both Britain and the United States expressed enthusiasm while also lamenting the games' physical and morale effects upon players, asking whether 'football' should be mended or ended.
Shindel, Alan W; Parish, Sharon J
Both the general public and individual patients expect healthcare providers to be knowledgeable and approachable regarding sexual health. Despite this expectation there are no universal standards or expectations regarding the sexuality education of medical students. To review the current state of the art in sexuality education for North American medical students and to articulate future directions for improvement. Evaluation of: (i) peer-reviewed literature on sexuality education (focusing on undergraduate medical students); and (ii) recommendations for sexuality education from national and international public health organizations. Current status and future innovations for sexual health education in North American medical schools. Although the importance of sexuality to patients is recognized, there is wide variation in both the quantity and quality of education on this topic in North American medical schools. Many sexual health education programs in medical schools are focused on prevention of unwanted pregnancy and sexually transmitted infection. Educational material on sexual function and dysfunction, female sexuality, abortion, and sexual minority groups is generally scant or absent. A number of novel interventions, many student initiated, have been implemented at various medical schools to improve the student's training in sexual health matters. There is a tremendous opportunity to mold the next generation of healthcare providers to view healthy sexuality as a relevant patient concern. A comprehensive and uniform curriculum on human sexuality at the medical school level may substantially enhance the capacity of tomorrow's physicians to provide optimal care for their patients irrespective of gender, sexual orientation, and individual sexual mores/beliefs. © 2013 International Society for Sexual Medicine.
Full Text Available Internet, cloud computing, social networks and mobile technology, all facilitate information transfer. Healthcare professionals, physicians and patients can use informatic devices in order to simplify their access to medical information, to streamline testing, and to understand clinical results. The use of computers and software facilitate doctor-patient interactions by optimizing communication and information flow. However, digital interfaces also increase the risks that information specialists use information without fully complying with ethical principles and laws in force. Our premise is that these information specialists should: 1 be informed of the rights, duties, and responsibilities linked to their profession and laws in force; 2 have guidelines and ethical tutoring on what they need to do in order to avoid or prevent conflict or misconduct; 3 have renewed specific training on how to interpret and translate legal frameworks into internal rules and standards of good practice. The purpose of this paper was: 1 to familiarize professionals who work in healthcare informatics with the ethical and legal issues related to their work; 2 to provide information about codes of ethics and legal regulations concerning this specific area; 3 to summarize some risks linked to wrong or inadequate use of patient information, such as medical, genetic, or personal data.
Bruce P Levy
Informatics candidates. Increasingly, these fellowships must be able to accommodate the needs of candidates anticipating a wide range of Pathology Informatics career paths, be able to accommodate Pathology′s increasingly subspecialized structure, and do this in a way that respects the multiple fellowships needed to become a subspecialty pathologist and informatician. This is further complicated as Pathology Informatics begins to look outward and takes its place in the growing, and still ill-defined, field of Clinical Informatics, a field that is not confined to just one medical specialty, to one way of practicing medicine, or to one way of providing patient care.
McGowan, Julie J; Passiment, Morgan; Hoffman, Helene M
As more health information technologies become part of the health care environment, the need for physicians with medical informatics competencies is growing. In 2006, a survey was created to determine the degree to which the Association of American Medical College's Medical School Objectives Project (MSOP) medical informatics competencies had been incorporated into medical school curricula in the United States. a web-based tool was used to create the survey; medical education deans or their designees were requested to complete the survey. Analysis focused on the clinician, researcher, and manager roles of physicians. Seventy usable surveys were returned. Many of the objectives were stated in the schools' respective curricula and the competencies were being evaluated. However, only a few schools taught and assessed the medical informatics objectives that required interaction with health information. To insure that physicians have the knowledge, skills, and attitudes to effectively and efficiently interact with today's health information technologies, more medical informatics concepts need to be included and assessed in all undergraduate medical education curricula in the United States.
Al-Shorbaji, Najeeb; Househ, Mowafa; Taweel, Adel; Alanizi, Abdullah; Mohammed, Bennani Othmani; Abaza, Haitham; Bawadi, Hala; Rasuly, Hamayon; Alyafei, Khalid; Fernandez-Luque, Luis; Shouman, Mohamed; El-Hassan, Osama; Hussein, Rada; Alshammari, Riyad; Mandil, Salah; Shouman, Sarah; Taheri, Shahrad; Emara, Tamer; Dalhem, Wasmiya; Al-Hamdan, Zaid; Serhier, Zineb
There has been a growing interest in Health Informatics applications, research, and education within the Middle East and North African Region over the past twenty years. People of this region share similar cultural and religious values, primarily speak the Arabic language, and have similar health care related issues, which are in dire need of being addressed. Health Informatics efforts, organizations, and initiatives within the region have been largely under-represented within, but not ignored by, the International Medical Informatics Association (IMIA). Attempts to create bonds and collaboration between the different organizations of the region have remained scattered, and often, resulted in failure despite the fact that the need for a united health informatics collaborative within the region has never been more crucial than today. During the 2017 MEDINFO, held in Hangzhou, China, a new organization, the Middle East and North African Health Informatics Association (MENAHIA) was conceived as a regional non-governmental organization to promote and facilitate health informatics uptake within the region endorsing health informatics research and educational initiatives of the 22 countries represented within the region. This paper provides an overview of the collaboration and efforts to date in forming MENAHIA and displays the variety of initiatives that are already occurring within the MENAHIA region, which MENAHIA will help, endorse, support, share, and improve within the international forum of health informatics. Georg Thieme Verlag KG Stuttgart.
Freemon, F R
The health status of the American slave in the 19th century remains unclear despite extensive historical research. Better knowledge of slave health would provide a clearer picture of the life of the slave, a better understanding of the 19th-century medicine, and possibly even clues to the health problems of modern blacks. This article hopes to contribute to the literature by examining another source of data. Slaves entering the Union Army joined an organization with standardized medical care that generated extensive statistical information. Review of these statistics answers questions about the health of young male blacks at the time American slavery ended.
Kaltoft, Mette Kjer
All healthcare visions, including that of The TIGER (Technology-Informatics-Guiding-Educational-Reform) Initiative envisage a crucial role for nursing. However, its 7 descriptive pillars do not address the disconnect between Nursing Informatics and Nursing Ethics and their distinct communities......-of-(care)-decision. Increased pressure for translating 'evidence-based' research findings into 'ethically-sound', 'value-based' and 'patient-centered' practice requires rethinking the model implicit in conventional knowledge translation and informatics practice in all disciplines, including nursing. The aim is to aid 'how...... nurses and other health care scientists more clearly identify clinical and other relevant data that can be captured to inform future comparative effectiveness research. 'A prescriptive, theory-based discipline of '(Nursing) Decisionics' expands the Grid for Volunteer Development of TIGER's newly launched...
Full Text Available A characteristic of the actual informatics’ context is the interference of the technologies, which assumes that for creating an informatics product, is necessary to use integrate many technologies. This thing is also used for database systems which had integrated, in the past few years, almost everything is new in informatics technology. The idea is that when using database management systems - DBMS the user can benefit all the necessary interfaces and instruments for developing an application with databases from the very beginning to the end, no matter the type of application and the work environment. For example, if the database application needs any Internet facilities these could be appealed from the products that the DBMS is working with offers. The concept of the interference of informatics technologies has many advantages, which all contribute to increasing the efficiency of the activities that develop and maintain complex databases applications.
Caballero Muñoz, Erika; Hullin Lucay Cossio, Carola M
This chapter gives an educational overview of: * The importance of the engagement of clinicians within a health informatics project * Strategies required for an effective involvement of clinicians throughout a change management process within a clinical context for the implementation of a health informatics project * The critical aspects for a successful implementation of a health informatics project that involves clinicians as end users * Key factors during the administration of changes during the implementation of an informatics project for an information system in clinical practice.
Hammond, Wizdom Powell; Matthews, Derrick; Mohottige, Dinushika; Agyemang, Amma; Corbie-Smith, Giselle
The contribution of masculinity to men's healthcare use has gained increased public health interest; however, few studies have examined this association among African-American men, who delay healthcare more often, define masculinity differently, and report higher levels of medical mistrust than non-Hispanic White men. To examine associations between traditional masculinity norms, medical mistrust, and preventive health services delays. A cross-sectional analysis using data from 610 African-American men age 20 and older recruited primarily from barbershops in the North, South, Midwest, and West regions of the U.S. (2003-2009). Independent variables were endorsement of traditional masculinity norms around self-reliance, salience of traditional masculinity norms, and medical mistrust. Dependent variables were self-reported delays in three preventive health services: routine check-ups, blood pressure screenings, and cholesterol screenings. We controlled for socio-demography, healthcare access, and health status. After final adjustment, men with a greater endorsement of traditional masculinity norms around self-reliance (OR: 0.77; 95% CI: 0.60-0.98) were significantly less likely to delay blood pressure screening. This relationship became non-significant when a longer BP screening delay interval was used. Higher levels of traditional masculinity identity salience were associated with a decreased likelihood of delaying cholesterol screening (OR: 0.62; 95% CI: 0.45-0.86). African-American men with higher medical mistrust were significantly more likely to delay routine check-ups (OR: 2.64; 95% CI: 1.34-5.20), blood pressure (OR: 3.03; 95% CI: 1.45-6.32), and cholesterol screenings (OR: 2.09; 95% CI: 1.03-4.23). Contrary to previous research, higher traditional masculinity is associated with decreased delays in African-American men's blood pressure and cholesterol screening. Routine check-up delays are more attributable to medical mistrust. Building on African-American men
Full Text Available Objective: To investigate American cockroaches' infection to various bacteria in Khorramshahr Vali-e-Asr hospital, which was done in 2008. Methods: In this descriptive cross-sectional study, 20 American cockroaches were caught via direct collection. Medically important bacteria were extracted from their outer surface of bodies by standard procedures. Results: Culturing outer surface wash of cockroaches resulted in the separation of Klebsiella, Pseudomonas, Escherichia coli, Staphylococcus, Proteus and Streptococcus. The main common bacteria were Klebsiella (35% and Pseudomonas (30%. Also, results of culture media showed that about 90% of cockroaches infected to at least one bacterium. Conclusions: American cockroaches can transmit pathogenic and potential pathogenic bacteria, therefore their presence in hospitals may be a sanitation challenge. It is recommended to assess plans in purpose to combat these pests in the hospitals.
Mouro, Gladys; Tashjian, Hera; Daaboul, Tania; Kozman, Katia; Alwan, Farah; Shamoun, Anthony
American University of Beirut Medical Center is the first Magnet hospital in the Middle East. In this article, authors reflect back on the journey to excellence, specifically in establishing shared governance in a challenging cultural and organizational milieu. Perspectives from nurses at different levels are included to highlight their experiences throughout the journey. Evolution of the organization's shared governance model is described and initiatives of the councils are illustrated.
Tucker-Seeley, Reginald D; Mitchell, Jamie A; Shires, Deirdre A; Modlin, Charles S
Health self-efficacy (the confidence to take care of one's health) is a key component in ensuring that individuals are active partners in their health and health care. The purpose of this study was to determine the association between financial hardship and health self-efficacy among African American men and to determine if unmet medical need due to cost potentially mediates this association. Cross-sectional analysis was conducted using data from a convenience sample of African American men who attended a 1-day annual community health fair in Northeast Ohio (N = 279). Modified Poisson regression models were estimated to obtain the relative risk of reporting low health self-efficacy. After adjusting for sociodemographic characteristics, those reporting financial hardship were 2.91 times, RR = 2.91 (confidence interval [1.24, 6.83]; p financial hardship and low health self-efficacy was no longer statistically significant. Our results suggest that the association between financial hardship and health self-efficacy can be explained by unmet medical need due to cost. Possible intervention efforts among African American men with low financial resources should consider expanding clinical and community-based health assessments to capture financial hardship and unmet medical need due to cost as potential contributors to low health self-efficacy. © 2014 Society for Public Health Education.
Hwang, Jessica P; Roundtree, Aimee K; Engebretson, Joan C; Suarez-Almazor, Maria E
Physicians can play a significant role in helping to decrease the hepatitis B virus (HBV) burden among Asian Americans. Few studies have described knowledge and practice patterns in the medical community among different provider types regarding HBV and liver cancer. Our study explores the HBV beliefs, attitudes and practice patterns of medical providers serving Asian American communities. We conducted three focus groups with primary care providers, liver specialists, and other providers predominantly serving Asian American community. We asked about practices and barriers to appropriate medical care and outreach. We moderated three focus groups with 23 participants, 18 of whom completed and returned demographic surveys. Twelve were of Asian ethnicity and 13 spoke English as a second language. Only eight screened at least half of their patients, most (72%) using the hepatitis B surface antigen test. We used grounded theory methods to analyze focus group transcripts. Participants frequently discussed cultural and financial barriers to hepatitis care. They admitted reluctance to screen for HBV because patients might be unwilling or unable to afford treatment. Cultural differences were discussed most by primary care providers; best methods of outreach were discussed most by liver specialists; and alternative medicine was discussed most by acupuncturists and other providers. More resources are needed to lower financial barriers complicating HBV care and encourage providing guideline-recommended screenings. Other providers can help promote HBV screening and increase community and cultural awareness.
Full Text Available The Transfusion Medicine Service (TMS covers diverse clinical and laboratory-based services that must be delivered with accuracy, efficiency and reliability. TMS oversight is shared by multiple regulatory agencies that cover product manufacturing and validation standards geared toward patient safety. These demands present significant informatics challenges. Over the past few decades, TMS information systems have improved to better handle blood product manufacturing, inventory, delivery, tracking and documentation. Audit trails and access to electronic databases have greatly facilitated product traceability and biovigilance efforts. Modern blood bank computing has enabled novel applications such as the electronic crossmatch, kiosk-based blood product delivery systems, and self-administered computerized blood donor interview and eligibility determination. With increasing use of barcoding technology, there has been a marked improvement in patient and specimen identification. Moreover, the emergence of national and international labeling standards such as ISBT 128 have facilitated the availability, movement and tracking of blood products across national and international boundaries. TMS has only recently begun to leverage the electronic medical record to address quality issues in transfusion practice and promote standardized documentation within institutions. With improved technology, future growth is expected in blood bank automation and product labeling with applications such as radio frequency identification devices. This article reviews several of these key informatics issues relevant to the contemporary practice of TMS.
Sharma, Gaurav; Parwani, Anil V; Raval, Jay S; Triulzi, Darrell J; Benjamin, Richard J; Pantanowitz, Liron
The Transfusion Medicine Service (TMS) covers diverse clinical and laboratory-based services that must be delivered with accuracy, efficiency and reliability. TMS oversight is shared by multiple regulatory agencies that cover product manufacturing and validation standards geared toward patient safety. These demands present significant informatics challenges. Over the past few decades, TMS information systems have improved to better handle blood product manufacturing, inventory, delivery, tracking and documentation. Audit trails and access to electronic databases have greatly facilitated product traceability and biovigilance efforts. Modern blood bank computing has enabled novel applications such as the electronic crossmatch, kiosk-based blood product delivery systems, and self-administered computerized blood donor interview and eligibility determination. With increasing use of barcoding technology, there has been a marked improvement in patient and specimen identification. Moreover, the emergence of national and international labeling standards such as ISBT 128 have facilitated the availability, movement and tracking of blood products across national and international boundaries. TMS has only recently begun to leverage the electronic medical record to address quality issues in transfusion practice and promote standardized documentation within institutions. With improved technology, future growth is expected in blood bank automation and product labeling with applications such as radio frequency identification devices. This article reviews several of these key informatics issues relevant to the contemporary practice of TMS.
Willoughby, Christopher D
Relying on a close reading of more than 4,000 medicals student theses, this essay explores the evolving medical approaches to race and environment in the early national and antebellum United States and highlights the role that medical school pedagogy played in disseminating and elaborating racial theory. Specifically, it considers the influence of racial science on medical concepts of the relationship of bodies to climates. At their core, monogenesis-belief in a single, unified human race-and polygenesis-the belief that each race was created separately-were theories about the human body's connections to the natural world. As polygenesis became influential in Atlantic medical thought, physicians saw environmental treatments as a matter of matching bodies to their natural ecology. In the first decades of the nineteenth century, Atlantic physicians understood bodies and places as in constant states of flux. Through proper treatment, people and environments could suffer either degradation or improvement. Practitioners saw African Americans and whites as the same species with their differences being largely superficial and produced by climate. However, by the 1830s and 1840s medical students were learning that each race was inherently different and unalterable by time or temperature. In this paradigm, medical students articulated a vision of racial health rooted in organic relationships between bodies and climates. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
McCloskey, Cindy B; Domen, Ronald E; Conran, Richard M; Hoffman, Robert D; Post, Miriam D; Brissette, Mark D; Gratzinger, Dita A; Raciti, Patricia M; Cohen, David A; Roberts, Cory A; Rojiani, Amyn M; Kong, Christina S; Peterson, Jo Elle G; Johnson, Kristen; Plath, Sue; Powell, Suzanne Zein-Eldin
Competency-based medical education has evolved over the past decades to include the Accreditation Council for Graduate Medical Education Accreditation System of resident evaluation based on the Milestones project. Entrustable professional activities represent another means to determine learner proficiency and evaluate educational outcomes in the workplace and training environment. The objective of this project was to develop entrustable professional activities for pathology graduate medical education encompassing primary anatomic and clinical pathology residency training. The Graduate Medical Education Committee of the College of American Pathologists met over the course of 2 years to identify and define entrustable professional activities for pathology graduate medical education. Nineteen entrustable professional activities were developed, including 7 for anatomic pathology, 4 for clinical pathology, and 8 that apply to both disciplines with 5 of these concerning laboratory management. The content defined for each entrustable professional activity includes the entrustable professional activity title, a description of the knowledge and skills required for competent performance, mapping to relevant Accreditation Council for Graduate Medical Education Milestone subcompetencies, and general assessment methods. Many critical activities that define the practice of pathology fit well within the entrustable professional activity model. The entrustable professional activities outlined by the Graduate Medical Education Committee are meant to provide an initial framework for the development of entrustable professional activity-related assessment and curricular tools for pathology residency training.
Haynes, Douglas M
In May 1870 the American Medical Association (AMA) voted to deny the admission of black delegates and their white colleagues to the national meeting in Washington, D.C. Historians of race and medicine have customarily viewed this decision as marking a crucial milestone in the formation of the nexus between racism and the development of the American medical profession in the era after the Civil War (1861-64). This study recasts this narrative by locating the 1870 decision in relation to the antebellum practices of the association and their social consequences for American medicine. It argues that the viability of the AMA as the national voice of the profession was critically dependent on rejecting racial equality. Indeed, at a moment when the question of the abolition of slavery polarized the nation, the AMA was founded in 1847 to create a voluntary professional organization, national in scope, dedicated to raising the standards of medical training and practice. To this end, the AMA elected presidents and selected host cities for annual meetings in the North, South, and West. Seven out of the fourteen meetings and six out of fourteen presidents were from slave and/or border states. These institutional practices together with the representation of blacks as different and enjoying an appropriate status as slaves grounded the national identity of the profession in black subordination. Similarly, the gendered discourses about healing and practices of female exclusion privileged medical authority as male by drawing on and reinforcing patriarchy. In the wake of the war, leaders hoped to restore the national character of the organization by resuming antebellum practices. In response to the new possibilities for blacks in medicine--as represented by the biracial National Medical Society--the AMA took steps to vigorously police the racial boundaries of the national profession. As this study will show, the 1870 decision reflected the logic of the racial politics at the heart
Walker, Laura E; Sadosty, Annie T; Colletti, James E; Goyal, Deepi G; Sunga, Kharmene L; Hayes, Sharonne N
Since 1995, women have comprised more than 40% of all medical school graduates. However, representation at leadership levels in medicine remains considerably lower. Gender representation among the American Board of Medical Specialties (ABMS) boards of directors (BODs) has not previously been evaluated. Our objective was to determine the relative representation of women on ABMS BODs and compare it with the in-training and in-practice gender composition of the respective specialties. The composition of the ABMS BODs was obtained from websites in March 2016 for all Member Boards. Association of American Medical Colleges and American Medical Association data were utilized to identify current and future trends in gender composition. Although represented by a common board, neurology and psychiatry were evaluated separately because of their very different practices and gender demographic characteristics. A total of 25 specialties were evaluated. Of the 25 specialties analyzed, 12 BODs have proportional gender representation compared with their constituency. Seven specialties have a larger proportion of women serving on their boards compared with physicians in practice, and 6 specialties have a greater proportion of men populating their BODs. Based on the most recent trainee data (2013), women have increasing workforce representation in almost all specialties. Although women in both training and practice are approaching equal representation, there is variability in gender ratios across specialties. Directorship within ABMS BODs has a more equitable gender distribution than other areas of leadership in medicine. Further investigation is needed to determine the reasons behind this difference and to identify opportunities to engage women in leadership in medicine. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
Pellowski, Jennifer A; Price, Devon M; Allen, Aerielle M; Eaton, Lisa A; Kalichman, Seth C
The purpose of this study was to examine the relationships between medical mistrust and trust and to determine if these measures differentially predict antiretroviral therapy (ART) medication adherence for African-American adults living with HIV. A total of 458 HIV positive African-Americans completed a cross-sectional survey. Self-reported ART adherence was collected using the visual-analog scale. The Beliefs About Medicines Questionnaire was used to assess medication necessity and concern beliefs. All measures of medical mistrust and trust were significantly negatively correlated, ranging from r = -.339 to -.504. Race-based medical mistrust significantly predicted medication necessity and concern beliefs, whereas general medical mistrust only significantly predicted medication concerns. Both measures of trust significantly predicted medication necessity beliefs and medication concerns. Higher levels of race-based medical mistrust predicted lower medication adherence, whereas, neither trust in own physician nor trust in health care provider significantly predicted medication adherence. However, trust in own physician significantly predicted medication necessity beliefs, which predicted medication adherence. Trust and mistrust are not simply opposites of one another. These findings provide evidence for the complexity of understanding the relationship between health care trust, mistrust and patient-related health beliefs and behaviours.
Design informatics—the use of computers as a means of generating, communicating and sharing data, information and knowledge in design—has been a central theme in design research and practice for many years. This paper reviews the recent progress of research in design informatics, and makes...
Eugenyia M. Butenina
Full Text Available The paper discusses Chekhovian ethical discourse in American fiction and non-fiction that forms part of an emerging literary canon of medical humanities in the USA. Besides Chekhov’s “medical” stories, special attention is given to his book Sakhalin Island seen as an object of “moral cartography.” The analysis of contemporary medical humanities in the USA shows that Chekhov’s ethical heritage has entered this field at several levels. One is teaching “medical” stories and Sakhalin Island as part of the future doctors’ ethical education. The other is expanding the literary-medical context by including these texts in comparative studies and anthologies. Finally, there is the overall level of developing the method of literary “diagnostic” bearing on Chekhov’s ethical heritage that is important for the study of both fiction and non-fiction authored by doctors-writers.
Winker, M A; Flanagin, A; Chi-Lum, B; White, J; Andrews, K; Kennett, R L; DeAngelis, C D; Musacchio, R A
Access to medical information via the Internet has the potential to speed the transformation of the patient-physician relationship from that of physician authority ministering advice and treatment to that of shared decision making between patient and physician. However, barriers impeding this transformation include wide variations in quality of content on the Web, potential for commercial interests to influence online content, and uncertain preservation of personal privacy. To address these issues, the American Medical Association (AMA) has developed principles to guide development and posting of Web site content, govern acquisition and posting of online advertising and sponsorship, ensure site visitors' and patients' rights to privacy and confidentiality, and provide effective and secure means of e-commerce. While these guidelines were developed for the AMA Web sites and visitors to these sites, they also may be useful to other providers and users of medical information on the Web. These principles have been developed with the understanding that they will require frequent revision to keep pace with evolving technology and practices on the Internet. The AMA encourages review and feedback from readers, Web site visitors, policymakers, and all others interested in providing reliable quality information via the Web.
Shortliffe, E H
The Internet provides one of the most compelling examples of the way in which government research investments can, in time, lead to innovations of broad social and economic impact. This paper reviews the history of the Internet's evolution, emphasizing in particular its relationship to medical informatics and to the nation's health-care system. Current national research programs are summarized and the need for more involvement by the informatics community and by federal health-care agencies is emphasized.
Kohli, Marc D; Warnock, Max; Daly, Mark; Toland, Christopher; Meenan, Chris; Nagy, Paul G
Over the past 20 years, imaging informatics has been driven by the widespread adoption of radiology information and picture archiving and communication and speech recognition systems. These three clinical information systems are commonplace and are intuitive to most radiologists as they replicate familiar paper and film workflow. So what is next? There is a surge of innovation in imaging informatics around advanced workflow, search, electronic medical record aggregation, dashboarding, and analytics tools for quality measures (Nance et al., AJR Am J Roentgenol 200:1064-1070, 2013). The challenge lies in not having to rebuild the technological wheel for each of these new applications but instead attempt to share common components through open standards and modern development techniques. The next generation of applications will be built with moving parts that work together to satisfy advanced use cases without replicating databases and without requiring fragile, intense synchronization from clinical systems. The purpose of this paper is to identify building blocks that can position a practice to be able to quickly innovate when addressing clinical, educational, and research-related problems. This paper is the result of identifying common components in the construction of over two dozen clinical informatics projects developed at the University of Maryland Radiology Informatics Research Laboratory. The systems outlined are intended as a mere foundation rather than an exhaustive list of possible extensions.
Yu, Mei-yu; Seetoo, Amy D; Hong, Oi Saeng; Song, Lixin; Raizade, Rekha; Weller, Adelwisa L Agas
Mammography and Pap smear tests are known to be effective early detection measures for breast and cervical cancers, respectively, but Asian Americans are reluctant to make visits for routine preventive care. Quantitative and qualitative research conducted by the Healthy Asian Americans Project (HAAP) between 1996 and 1999 indicated that Asian residents in southeastern Michigan, like the general Asian population in the US, underutilized early cancer screening programs due to cultural, psychosocial, linguistic, and economic barriers. This article reports how the HAAP's research findings guided the Michigan Breast and Cervical Cancer Control Program (BCCCP) promotion (conducted from 2000 to 2001 among medically underserved Asian women residing in southeastern Michigan), and how evaluation of the HAAP's BCCCP promotion will direct future research and health promotion programs. The article presents strategies used to improve access to cancer screening programs for diverse Asian sub-groups as well as outcomes of the 2-year HAAP's BCCCP promotion among the target population. Discussion regarding lessons and experiences gained from integration of research and practice has implications on design and implementation of the cancer screening promotion for the rapidly increasing Asian American population as well as other medically underserved minority populations in the US.
Lassen, Jens Vejrup; Simonsen, Jesper
We present an ethnographic study of the organizational aspects of the use of an electronic whiteboard (EW) system implemented in a Danish hospital located in Nykøbing Falster (NFH). The EW system had originally been developed for the emergency department (ED), but had later been extended to the e...... and demonstrate the complexity of organizing cooperative work using artifacts and technology across organizational units....
Schofferman, Jerome A; Eskay-Auerbach, Marjorie L; Sawyer, Laura S; Herring, Stanley A; Arnold, Paul M; Muehlbauer, Eric J
Recently the financial relationships between industry and professional medical associations have come under increased scrutiny because of the concern that industry ties may create real or perceived conflicts of interest. Professional medical associations pursue public advocacy as well as promote medical education, develop clinical practice guidelines, fund research, and regulate professional conduct. Therefore, the conflicts of interest of a professional medical association and its leadership can have more far-reaching effects on patient care than those of an individual physician. Few if any professional medical associations have reported their experience with implementing strict divestment and disclosure policies, and among the policies that have been issued, there is little uniformity. We describe the experience of the North American Spine Society (NASS) in implementing comprehensive conflicts of interest policies. A special feature article. We discuss financial conflicts of interest as they apply to professional medical associations rather than to individual physicians. We describe the current policies of disclosure and divestment adopted by the NASS and how these policies have evolved, been refined, and have had no detrimental impact on membership, attendance at annual meetings, finances, or leadership recruitment. No funding was received for this work. The authors report no potential conflict-of-interest-associated biases in the text. The NASS has shown that a professional medical association can manage its financial relationships with industry in a manner that minimizes influence and bias. The NASS experience can provide a template for other professional medical associations to help manage their own possible conflicts of interest issues. Copyright © 2013 Elsevier Inc. All rights reserved.
Acton Ronald T
Full Text Available Abstract Background Results of previous autopsy studies indicate that increased hepatic iron stores or hepatic iron overload is common in African Americans dying in hospitals, but there are no reports of hepatic iron content in other cohorts of African Americans. Methods We investigated the prevalence of heavy liver iron deposition in African American adults. Using established histochemical criteria, we graded Perls' acid ferrocyanide-reactive iron in the hepatocytes and Kupffer cells of 341 consecutive African American adults who were autopsied in the coroner/medical examiner office. Heavy staining was defined as grade 3 or 4 hepatocyte iron or grade 3 Kupffer cell iron. Results There were 254 men and 85 women (mean age ± 1 SD: 44 ± 13 y vs. 48 ± 14 y, respectively; p = 0.0255; gender was unstated or unknown in two subjects. Approximately one-third of subjects died of natural causes. Heavy staining was observed in 10.2% of men and 4.7% of women. 23 subjects had heavy hepatocyte staining only, six had heavy Kupffer cell staining only, and one had a mixed pattern of heavy staining. 15 subjects had histories of chronic alcoholism; three had heavy staining confined to hepatocytes. We analyzed the relationships of three continuous variables (age at death in years, hepatocyte iron grade, Kupffer cell iron grade and two categorical variables (sex, cause of death (natural and non-natural causes in all 341 subjects using a correlation matrix with Bonferroni correction. This revealed two positive correlations: hepatocyte with Kupffer cell iron grades (p Conclusions The present results confirm and extend previous observations that heavy liver iron staining is relatively common in African Americans. The pertinence of these observations to genetic and acquired causes of iron overload in African Americans is discussed.
A. A. Kosolapov
Full Text Available Purpose.Computerization and informatization in recent decades gave the mankind automated electronic document management systems, automated process of production, Internet and network information resources WWW, expanded the communications capabilities and led to the globalization of the information society. At the same time gives rise to a number of processes of informatization philosophical and anthropological problems, that has become an existential character. It is necessary to identify and understanding of these issues on the basis of the gnoseological model of the evolution informatization paradigms and determine their main characteristics. Methodology. The system-activity approach was used; it allowed identifying and analyzing the impact of the main components of information and communication technologies (ICT for educational activities. And further to present them as a unified system of human activity in conditions computerization/informatization. The philosophical principles: a comprehensive review of the subject, the unity of the logical and historical, ascending from the abstract to the concrete was used. The general scientific principles: unity and development of the system, the decomposition hierarchy, individualization and cooperation, diversity and taxonomy were applied. Findings.The three-stage gnoseological model of the paradigms computerization/informatization evolution was proposed by the author. It is based on three information system characteristics: speed, interface and data access. The seven-bar anthrop-centric model, which is called the architecture of information systems (AIS, which describes the changes in their types of procuring, was proposed for each paradigm. The philosophical-anthropological problems that affect negatively its progress were formulated for each stage of modern information society transformation. Originality. The gnoseological model of development processes of informatization in the form of three
Background Biodiversity informatics is a relatively new discipline extending computer science in the context of biodiversity data, and its development to date has not been uniform throughout the world. Digitizing effort and capacity building are costly, and ways should be found to prioritize them rationally. The proposed 'Biodiversity Informatics Potential (BIP) Index' seeks to fulfill such a prioritization role. We propose that the potential for biodiversity informatics be assessed through three concepts: (a) the intrinsic biodiversity potential (the biological richness or ecological diversity) of a country; (b) the capacity of the country to generate biodiversity data records; and (c) the availability of technical infrastructure in a country for managing and publishing such records. Methods Broadly, the techniques used to construct the BIP Index were rank correlation, multiple regression analysis, principal components analysis and optimization by linear programming. We built the BIP Index by finding a parsimonious set of country-level human, economic and environmental variables that best predicted the availability of primary biodiversity data accessible through the Global Biodiversity Information Facility (GBIF) network, and constructing an optimized model with these variables. The model was then applied to all countries for which sufficient data existed, to obtain a score for each country. Countries were ranked according to that score. Results Many of the current GBIF participants ranked highly in the BIP Index, although some of them seemed not to have realized their biodiversity informatics potential. The BIP Index attributed low ranking to most non-participant countries; however, a few of them scored highly, suggesting that these would be high-return new participants if encouraged to contribute towards the GBIF mission of free and open access to biodiversity data. Conclusions The BIP Index could potentially help in (a) identifying countries most likely to
Physicians figured prominently in the resurgence of nuclear weapons activism and cultural awareness that swept the US in the early 1980s. This discussion seeks to place this activism in historical context. It explores the American medical profession's shifting engagement with the issue of nuclear war. Attention is focused on the period 1945 to 1954, with a brief evaluation of the period 1954 to 1963, the years to which the activism of the 1980s may be traced. Radiation studies are reviewed including Hiroshima and Nagasaki survivors. Radiological studies were begun within days of Japan's surrender. The delayed effects of radiation exposure on some 14,000 persons in Hiroshima and Nagasaki include hemorrhage, leukocyte destruction, bone marrow damage, anemia, sterility, and the suppression of menstruation. In contrast, the American medical profession in the late 1940s focused much attention on the atom's potential medical benefits, especially the diagnostic and treatment value of radioisotopes. 90 references.
Mayta-Tristán, Percy; Montenegro-Idrogo, Juan José; Mejia, Christian R.; Abudinén A., Gabriel; Azucas-Peralta, Rita; Barrezueta-Fernandez, Jorge; Cerna-Urrutia, Luis; DaSilva-DeAbreu, Adrián; Mondragón-Cardona, Alvaro; Moya, Geovanna; Valverde-Solano, Christian D.; Theodorus-Villar, Rhanniel; Vizárraga-León, Maribel
Background The shortage in Latin-American Primary Care (PC) workforce may be due to negative perceptions about it. These perceptions might be probably influenced by particular features of health systems and academic environments, thus varying between countries. Methods Observational, analytic and cross-sectional multicountry study that evaluated 9,561 first and fifth-year medical students from 63 medical schools of 11 Latin American countries through a survey. Perceptions on PC work was evaluated through a previously validated scale. Tertiles of the scores were created in order to compare the different countries. Crude and adjusted prevalence ratios were calculated using simple and multiple Poisson regression with robust variance. Results Approximately 53% of subjects were female; mean age was 20.4±2.9 years; 35.5% were fifth-year students. Statistically significant differences were found between the study subjects’ country, using Peru as reference. Students from Chile, Colombia, Mexico and Paraguay perceived PC work more positively, while those from Ecuador showed a less favorable position. No differences were found among perceptions of Bolivian, Salvadoran, Honduran and Venezuelan students when compared to their Peruvian peers. Conclusions Perceptions of PC among medical students from Latin America vary according to country. Considering such differences can be of major importance for potential local specific interventions. PMID:27414643
Eric L. Anderson
Full Text Available Introduction: In the United States, the number of patients presenting to the emergency department (ED for a mental health concern is significant and expected to grow. The breadth of the medical evaluation of these patients is controversial. Attempts have been made to establish a standard evaluation for these patients, but to date no nationally accepted standards exist. A task force of the American Association of Emergency Psychiatry, consisting of physicians from emergency medicine and psychiatry, and a psychologist was convened to form consensus recommendations on the medical evaluation of psychiatric patients presenting to EDs. Methods: The task force reviewed existing literature on the topic of medical evaluation of psychiatric patients in the ED (Part I and then combined this with expert consensus (Part II. Results: In Part I, we discuss terminological issues and existing evidence on medical exams and laboratory studies of psychiatric patients in the ED. Conclusion: Emergency physicians should work cooperatively with psychiatric receiving facilities to decrease unnecessary testing while increasing the quality of medical screening exams for psychiatric patients who present to EDs. [West J Emerg Med. 2017;18(2235-242.
Nora, Lois Margaret; Pouwels, Mellie Villahermosa; Irons, Mira
The American Board of Medical Specialties board certification has transformed into a career-long process of learning, assessment, and performance improvement through its Program for Maintenance of Certification (MOC). Medical educators across many medical professional organizations, specialty societies, and other institutions have played important roles in shaping MOC and tailoring its overarching framework to the needs of different specialties. This Commentary addresses potential barriers to engagement in work related to MOC for medical school (MS) and academic health center (AHC) educators and identifies reasons for, and ways to accomplish, greater involvement in this work. The authors present ways that medical and other health professions educators in these settings can contribute to the continuous improvement of the MOC program including developing educational and assessment activities, engaging in debate about MOC, linking MOC with institutional quality improvement activities, and pursuing MOC-related scholarship. MS- and AHC-based educators have much to offer this still-young and continually improving program, and their engagement is sought, necessary, and welcomed.
Whelan, Emma; Asbridge, Mark; Haydt, Susan
BACKGROUND: There are public concerns regarding OxyContin (Purdue Pharma, Canada) and charges within the pain medicine community that media coverage of the drug has been biased. OBJECTIVE: To analyze and compare representations of OxyContin in medical journals and North American newspapers in an attempt to shed light on how each contributes to the ‘social problem’ associated with OxyContin. METHODS: Using searches of newspaper and medical literature databases, two samples were drawn: 924 stories published between 1995 and 2005 in 27 North American newspapers, and 197 articles published between 1995 and 2007 in 33 medical journals in the fields of addiction/substance abuse, pain/anesthesiology and general/internal medicine. The foci, themes, perspectives represented and evaluations of OxyContin presented in these texts were analyzed statistically. RESULTS: Newspaper coverage of OxyContin emphasized negative evaluations of the drug, focusing on abuse, addiction, crime and death rather than the use of OxyContin for the legitimate treatment of pain. Newspaper stories most often conveyed the perspectives of law enforcement and courts, and much less often represented the perspectives of physicians. However, analysis of physician perspectives represented in newspaper stories and in medical journals revealed a high degree of inconsistency, especially across the fields of pain medicine and addiction medicine. CONCLUSION: The prevalence of negative representations of OxyContin is often blamed on biased media coverage and an ignorant public. However, the proliferation of inconsistent messages regarding the drug from physicians plays a role in the drug’s persistent status as a social problem. PMID:22059195
Song, Insu; Yellowlees, Peter; Diederich, Joachim
This book introduces approaches that have the potential to transform the daily practice of psychiatrists and psychologists. This includes the asynchronous communication between mental health care providers and clients as well as the automation of assessment and therapy. Speech and language are particularly interesting from the viewpoint of psychological assessment. For instance, depression may change the characteristics of voice in individuals and these changes can be detected by a special form of speech analysis. Computational screening methods that utilise speech and language can detect subtle changes and alert clinicians as well as individuals and caregivers. The use of online technologies in mental health, however, poses ethical problems that will occupy concerned individuals, governments and the wider public for some time. Assuming that these ethical problems can be solved, it should be possible to diagnose and treat mental health disorders online (excluding the use of medication).
Timmermann, Arnd; Russo, Sebastian G.; Hollmann, Markus W.
Purpose of review Much controversy exists about who can provide the best medical care for critically ill patients in the prehospital setting. The Anglo-American concept is on the whole to provide well trained paramedics to fulfil this task, whereas in some European countries emergency medical
Full Text Available The objective, necessity, means and estimated efficiency of information security cost modeling are presented. The security requirements of distributed informatics applications are determined. Aspects regarding design, development and implementation are established. Influence factors for informatics security are presented and their correlation is analyzed. The costs associated to security processes are studied. Optimal criteria for informatics security are established. The security cost of the informatics application for validating organizational identifiers is determined using theoretical assumptions made for cost models. The conclusions highlight the validity of research results and offer perspectives for future research.
Shaw, Nicola; McGuire, Suzanne
The purpose of this literature review is to understand geographical information systems (GIS) and how they can be applied to public health informatics, medical informatics, and epidemiology. Relevant papers that reflected the use of geographical information systems (GIS) in health research were identified from four academic databases: Academic Search Complete, BioMed Central, PubMed Central, and Scholars Portal, as well as Google Scholar. The search strategy used was to identify articles with "geographic information systems", "GIS", "public health", "medical informatics", "epidemiology", and "health geography" as main subject headings or text words in titles and abstracts. Papers published between 1997 and 2014 were considered and a total of 39 articles were included to inform the authors on the use of GIS technologies in health informatics research. The main applications of GIS in health informatics and epidemiology include disease surveillance, health risk analysis, health access and planning, and community health profiling. GIS technologies can significantly improve quality and efficiency in health research as substantial connections can be made between a population's health and their geographical location. Gains in health informatics can be made when GIS are applied through research, however, improvements need to occur in the quantity and quality of data input for these systems to ensure better geographical health maps are used so that proper conclusions between public health and environmental factors may be made.
Perry, Sylvia P; Hardeman, Rachel; Burke, Sara E; Cunningham, Brooke; Burgess, Diana J; van Ryn, Michelle
Positive psychological well-being is an important predictor of and contributor to medical student success. Previous work showed that first-year African American medical students whose self-concept was highly linked to their race (high racial identity centrality) were at greater risk for poor well-being. The current study extends this work by examining (a) whether the psychological impact of racial discrimination on well-being depends on African American medical students' racial identity centrality and (b) whether this process is explained by how accepted students feel in medical school. This study used baseline data from the Medical Student Cognitive Habits and Growth Evaluation (CHANGE) Study, a large national longitudinal cohort study of 4732 medical students at 49 medical schools in the USA (n = 243). Regression analyses were conducted to test whether medical student acceptance mediated an interactive effect of discrimination and racial identity centrality on self-esteem and well-being. Both racial identity centrality and everyday discrimination were associated with negative outcomes for first-year African American medical students. Among participants who experienced higher, but not lower, levels of everyday discrimination, racial identity centrality was associated with negative outcomes. When everyday discrimination was high, but not low, racial identity was negatively related to perceived acceptance in medical school, and this in turn was related to increased negative outcomes. Our results suggest that discrimination may be particularly harmful for African American students who perceive their race to be central to their personal identity. Additionally, our findings speak to the need for institutional change that includes commitment and action towards inclusivity and the elimination of structural racism.
Wells, Janie R
The purpose of this three-group quasi-experimental research study was to describe the relationship between hemodialysis knowledge and perceived medical adherence to a prescribed treatment regimen in African Americans diagnosed with end stage renal disease and to determine if an educational intervention improved hemodialysis knowledge and medical adherence. Eighty-five African Americans participated in this study using the Life Options Hemodialysis Knowledge Test and the Medical Outcomes Study Measures of Patient Adherence tools. No significant correlation was found between hemodialysis knowledge and medical adherence. Paired sample t-tests revealed significantly higher hemodialysis knowledge scores in the post-test group compared to the pre-test group, t(26) = -3.79, p adherence. This study suggests that more education is needed to improve the knowledge level of African-American patients on hemodialysis.
Recent scholarship argues that successful international medical collaboration depends crucially on improving cross-cultural understanding. To this end, this study analyzes recent writings on medical ethics by physicians in two countries actively participating in global medicine, Thailand and the United States. Articles (133; published 2004-2008) from JAMA, the New England Journal of Medicine, and the Journal of the Medical Association of Thailand are analyzed to inductively build a portrait of two discursive ethical cultures. Frameworks of moral reasoning are identified across and within the two groups, with a focus on what authority (religion, law, etc.) is invoked to define and evaluate ethical problems. How might similarities and differences in ethical paradigms reflect the countries' historical "semicolonial" relationship, shed light on debates about Eastern vs. Western bioethics, and facilitate or hinder contemporary cross-national communication? Findings demonstrate substantial overlap in Thai and American doctors' vocabulary, points of reference, and topics covered, though only Thai doctors emphasize national interests and identity. American authors display a striking homogeneity in styles of moral reasoning, embracing a secular, legalistic, deontological ethics that generally eschews discussion of religion, personal character, or national culture. Among Thai authors, there is a schism in ethical styles: while some hew closely to the secular, deontological model, others embrace a virtue ethics that liberally cites Buddhist principles and emphasizes the role of doctors' good character. These two approaches may represent opposing reactions-assimilation and resistance, respectively-to Western influence. The current findings undermine the stereotype of Western individualism versus Eastern collectivism. Implications for cross-national dialog are discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.
Casas, Alejandro; Montes de Oca, Maria; Menezes, Ana Mb; Wehrmeister, Fernando C; Lopez Varela, Maria Victorina; Mendoza, Laura; Ramírez, Larissa; Miravitlles, Marc
Limited information is available regarding medication use in COPD patients from Latin America. This study evaluated the type of medication used and the adherence to different inhaled treatments in stable COPD patients from the Latin American region. This was an observational, cross-sectional, multinational, and multicenter study in COPD patients attended by specialist doctors from seven Latin American countries. Adherence to inhaled therapy was assessed using the Test of Adherence to Inhalers (TAI) questionnaire. The type of medication was assessed as: short-acting β-agonist (SABA) or short-acting muscarinic antagonist (SAMA) only, long-acting muscarinic antagonist (LAMA), long-acting β-agonist (LABA), LABA/LAMA, inhaled corticosteroid (ICS), ICS/LABA, ICS/LAMA/LABA, or other. In total, 795 patients were included (59.6% male), with a mean age of 69.5±8.7 years and post-bronchodilator FEV 1 of 50.0%±18.6%. The ICS/LAMA/LABA (32.9%) and ICS/LABA (27.7%) combinations were the most common medications used, followed by LABA/LAMA (11.3%), SABA or SAMA (7.9%), LABA (6.4%), LAMA (5.8%), and ICS (4.3%). The types of medication most commonly used in each Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2013 category were ICS/LABA (A: 32.7%; B: 19.8%; C: 25.7%; D: 28.2%) and ICS/LAMA/LABA (A: 17.3%; B: 30.2%; C: 33%; D: 41.1%). The use of long-acting bronchodilators showed the highest adherence (good or high adherence >50%) according to the TAI questionnaire. COPD management in specialist practice in Latin America does not follow the current guideline recommendations and there is an overuse of ICSs in patients with COPD from this region. Treatment regimens including the use of long-acting bronchodilators are associated with the highest adherence.
Marc S. Williams
Full Text Available The proposed Precision Medicine Initiative has the potential to transform medical care in the future through a shift from interventions based on evidence from population studies and empiric response to ones that account for a range of individual factors that more reliably predict response and outcomes for the patient. Many things are needed to realize this vision, but one of the most critical is an informatics workforce that has broad interdisciplinary training in basic science, applied research and clinical implementation. Current approaches to informatics training do not support this requirement. We present a collaborative model of training that has the potential to produce a workforce prepared for the challenges of implementing precision medicine.
Clough, S; Shehabi, Z; Morgan, C
Medical risk assessment is essential to safe patient management and the delivery of appropriate dental care. The American Society of Anesthesiologists Physical Status (ASA PS) Classification is widely used within medicine and dentistry, but has received significant criticism. This is the first UK survey to assess the consistency of medical risk assessment in dentistry. (i) To determine the use and consistency of the ASA PS among dentists and anaesthetists. (ii) To consider the appropriateness of the ASA PS in relation to dental treatment planning and delivery of care. A cross-sectional online questionnaire was distributed to anaesthetists and dental practitioners in general practice, community and hospital dental services. Questions focused on professional backgrounds, use of the ASA PS, alternative approaches to risk assessment in everyday practice and scoring of eight hypothetical patients using ASA PS. There were 101 responses, 82 were complete. Anaesthetists recorded ASA PS score more frequently than dental practitioners and found it more useful. Inconsistencies were evident in the assignment of ASA PS scores both between and within professional groups. Many dental practitioners did not use or find ASA PS helpful, with significant inconsistencies in its use. An awareness of alternative assessment scales may be useful across settings. Accepting its limitations, it would be helpful for all dentists to be educated in ASA PS and its use in medical risk assessment, particularly in relation to conscious sedation.
Technological advancements in the health care field have always impacted the health care practices. Nursing practice has also been greatly influenced by the technology. In the recent years, use of information technology including computers, handheld digital devices, internet has advanced the nursing by bridging the gap from nursing as an art to nursing as science. In every sphere of nursing practice, nursing research, nursing education and nursing informatics play a very important role. If used properly it is a way to save time, helping to provide quality nursing care and increases the proficiency of nursing personnel.
""This book will be a terrific introduction to the field of clinical IT and clinical informatics"" -- Kevin Johnson ""Dr. Braunstein has done a wonderful job of exploring a number of key trends in technology in the context of the transformations that are occurring in our health care system"" -- Bob Greenes ""This insightful book is a perfect primer for technologists entering the health tech field."" -- Deb Estrin ""This book should be read by everyone."" -- David Kibbe This book provides care providers and other non-technical readers with a broad, practical overview of the changi
Sora, Sebastian A.
Informatics is a branch of computer science that concerns itself, in actuality, with the use of information systems. The objective of this paper is to focus on the business curriculum for graduate students and their gaining proficiency in informatics so that they can understand the concept of information, the access of information, the use of…
Rwanda Journal Series F: Medicine and Health Sciences Vol. ... establishment of continuous on-the-job training in health informatics for those ... deals with the resources, devices and formalized methods .... informatics competencies in undergraduate level, the tool ... Descriptive statistics were used to describe numerical.
Butani, Lavjay; Bannister, Susan L; Rubin, Allison; Forbes, Karen L
The objectives of this study were to explore pediatric undergraduate medical educators' understanding of reflective practice, the barriers they face in teaching this, the curricular activities they use, and the value they assign to reflective practice. Nine survey questions were sent to members of the Council on Medical Student Education in Pediatrics, an international pediatric undergraduate medical educator group. Quantitative data were analyzed using descriptive statistics. Open-ended responses were analyzed qualitatively through an iterative process to establish themes representing understanding of reflective practice and barriers in teaching this. Respondents representing 56% of all North American schools answered at least 1 survey question. Qualitative analysis of understanding of reflection revealed 11 themes spanning all components of reflective practice, albeit with a narrow view on triggers for reflection and a lower emphasis on understanding the why of things and on perspective-taking. The most frequent barriers in teaching this were the lack of skilled educators and limited time. Most respondents valued reflective skills but few reported confidence in their ability to teach reflection. Several curricular activities were used to teach reflection, the most common being narrative writing. Pediatric undergraduate medical educators value reflection and endorse its teaching. However, many do not have a complete understanding of the construct and few report confidence in teaching this. Implementing longitudinal curricula in reflective practice may require a culture change; opportunities exist for faculty development about the meaning and value of reflective practice and how best to teach this. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
Sirintrapun, S Joseph; Zehir, Ahmet; Syed, Aijazuddin; Gao, JianJiong; Schultz, Nikolaus; Cheng, Donavan T
Translational bioinformatics and clinical research (biomedical) informatics are the primary domains related to informatics activities that support translational research. Translational bioinformatics focuses on computational techniques in genetics, molecular biology, and systems biology. Clinical research (biomedical) informatics involves the use of informatics in discovery and management of new knowledge relating to health and disease. This article details 3 projects that are hybrid applications of translational bioinformatics and clinical research (biomedical) informatics: The Cancer Genome Atlas, the cBioPortal for Cancer Genomics, and the Memorial Sloan Kettering Cancer Center clinical variants and results database, all designed to facilitate insights into cancer biology and clinical/therapeutic correlations. Copyright © 2015 Elsevier Inc. All rights reserved.
: Women account for 16% of deans of American medical schools. To investigate this gender gap, female deans were interviewed about the barriers facing women advancing toward deanships. The author conducted semi-structured interviews with eight women deans. Interviews were analyzed using provisional coding and sub coding techniques. Four main themes emerged during the interviews: (1) the role of relationships in personal and career development, (2) leadership challenges, (3) barriers between women and leadership advancement, and (4) recommendations for improvement. Recommendations included allocating resources, mentorship, career flexibility, faculty development, updating the criteria for deanships, and restructuring search committees. The barriers identified by the deans are similar to those found in previous studies on female faculty and department chairs, suggesting limited improvement in gender equity progress.
Perez, M. R.; Valverde, N.; Sanhueza, S.; Di Tramo, J. L.; Gisone, P.; Cardenas, J.
In Latin America exists a wide application of the nuclear techniques in different fields. These tendencies, to the increasing use of nuclear techniques, should carry out the invigoration of the infrastructures and the development of the authorities in radiation protection charge of the regulate and control the sources and practical, associated to ionizing radiation, guided to guarantee their safe use and in consequence to minimize the derived risks of the same ones. In spite of the efforts before mentioned a potential possibility of occurrence of accidental radiological events linked to human errors and violation's of the principles of the radiation protection exists. Reason that they advise to have response capacities to confront and to mitigate the consequences in situations of radiological accidents, including in the same ones the medical assistance of the accident victims. However, the radiological accidents happened in the international environment in the last decades, they have demonstrated inability paradoxically to confront with effectiveness these fortuitous events. Being characterized additionally by the insufficient training of the medical professionals to interpret and to act in consequence before the prejudicial effects to the health of the ionizing radiation. In our geographical context this situation is even more complicated, if we consider the happened radiological accidents of span that put in risk the life and the health of people involved in the same ones, for examples: Argentina (1968, 1963), Brazil (1985, 1987, 1995), Costa Rica (1996). El Salvador (1989), Mexico (1962, 1983, 1984) and Peru (1984, 1999). These reasons justify the development of an action program with the purpose of the consolidate and to integrate the capacity of response of our countries as regards radiological emergencies. Regrettably in Latin American subsist inequalities the development radiation protection programs, that propitiate the possibility of accidental situations
Hossain, S; Jalil, S; Guerrero, D M; Sahmoun, A E
The prevalence of chronic liver disease (CLD) in the Aboriginal North American population is disproportionately higher than that of the non-indigenous population. Hepatitis C virus (HCV) is the second leading cause of CLD in American Indians or Alaska Natives (AIANs). This study described the experience of two teaching community medical centers in North Dakota in treating HCV infection among AIANs and compared treatment outcomes to a cohort of Caucasian patients. The retrospective study described the characteristics and proportion of AIAN patients with HCV who received treatment. Documented reasons for not receiving treatment were analyzed. For those AIAN patients treated for HCV infection, responses to treatment, including rapid, early and sustained virological responses (SVRs), were compared with those of Caucasians. Only 22 (18%) of 124 AIANs with HCV infection received treatment. Common reasons for not receiving treatment include lack of access to specialists, concomitant or decompensated liver disease, alcohol and drug abuse and cost. There were no significant differences in the baseline characteristics and key predictors of SVR in AIANs compared to Caucasian controls. Most AIAN patients with HCV infection do not receive treatment despite comparable treatment response rates to Caucasians. Further population-based studies, addressing access to specialized hepatitis C treatment and public health concerns are warranted, as it is crucial to treat chronic HCV infection to decrease the burden of disease in the AIAN community.
Garcia, Edna; Ali, Asma M; Soles, Ryan M; Lewis, D Grace
To determine the extent and distribution of workforce shortages within the nation's medical laboratories. Historically, the results of this biennial survey have served as a basis for additional research on laboratory recruitment, retention, education, marketing, certification, and advocacy. The 2014 Vacancy Survey was conducted through collaboration between American Society for Clinical Pathology's Institute of Science, Technology, and Policy in Washington, DC, and the Evaluation, Measurement, and Assessment Department and Board of Certification in Chicago, Illinois. Data were collected via an Internet survey that was distributed to individuals who were able to report on staffing and certifications for their laboratories. Data reveal increased overall vacancy rates since 2012 for all departments surveyed except cytology and cytogenetics. Also, results show higher anticipated retirement rates for both staff and supervisors. Overall certification rates are highest among laboratory personnel in cytogenetics, hematology/coagulation, and flow cytometry departments and lowest among phlebotomy, specimen processing, and anatomic pathology. Factors such as retirement and the improving economy are driving the need for more laboratory professionals. Recruitment of qualified laboratory professionals in the workforce and students in laboratory programs will be the key in fulfilling the higher vacancies revealed from the survey results in 2014. Copyright© by the American Society for Clinical Pathology.
Web 3.0 promises us smart computer services that will interact with each other and leverage knowledge about us and our immediate context to deliver prioritised and relevant information to support decisions and actions. Healthcare must take advantage of such new knowledge-integrating services, in particular to support better co-operation between professionals of different disciplines working in different locations, and to enable well-informed co-operation between clinicians and patients. To grasp the potential of Web 3.0 we will need well-harmonised semantic resources that can richly connect virtual teams and link their strategies to real-time and tailored evidence. Facts, decision logic, care pathway steps, alerts, education need to be embedded within components that can interact with multiple EHR systems and services consistently. Using Health Informatics 3.0 a patient's current situation could be compared with the outcomes of very similar patients (from across millions) to deliver personalised care recommendations. The integration of EHRs with biomedical sciences ('omics) research results and predictive models such as the Virtual Physiological Human could help speed up the translation of new knowledge into clinical practice. The mission, and challenge, for Health Informatics 3.0 is to enable healthy citizens, patients and professionals to collaborate within a knowledge-empowered social network in which patient specific information and personalised real-time evidence are seamlessly interwoven.
Salas, A A; Anderson, M B
Previous articles in this column have discussed how new information technologies are revolutionizing medical education. In this article, two staff members from the Association of American Medical College's Division of Medical Education discuss how the Association (the AAMC) is working both to support the introduction of new technologies into medical education and to facilitate dialogue on information technology and curriculum issues among AAMC constituents and staff. The authors describe six AAMC initiatives related to computing in medical education: the Medical School Objectives Project, the National Curriculum Database Project, the Information Technology and Medical Education Project, a professional development program for chief information officers, the AAMC ACCESS Data Collection and Dissemination System, and the internal Staff Interest Group on Medical Informatics and Medical Education.
Gabril, Manal Y; Yousef, George M
Informatics can be defined as using highly advanced technologies to improve patient diagnosis or management. Pathology informatics had evolved as a response to the overwhelming amount of information that was available, in an attempt to better use and maintain them. The most commonly used tools of informatics can be classified into digital imaging, telepathology, as well as Internet and electronic data mining. Digital imaging is the storage of anatomical pathology information, either gross pictures or microscopic slides, in an electronic format. These images can be used for education, archival, diagnosis, and consultation. Virtual microscopy is the more advanced form of digital imaging with enhanced efficiency and accessibility. Telepathology is now increasingly becoming a useful tool in anatomical pathology practice. Different types of telepathology communications are available for both diagnostic and consultation services. The spectrum of applications of informatics in the field of anatomical pathology is broad and encompasses medical education, clinical services, and pathology research. Informatics is now settling on solid ground as an important tool for pathology teaching, with digital teaching becoming the standard tool in many institutions. After a slow start, we now witness the transition of informatics from the research bench to bedside. As we are moving into a new era of extensive pathology informatics utilization, several challenges have to be addressed, including the cost of the new technology, legal issues, and resistance of pathologists. It is clear from the current evidence that pathology informatics will continue to grow and have a major role in the future of our specialty. However, it is also clear that it is not going to fully replace the human factor or the regular microscope.
Larson, Lisa R.
Nursing program leadership for integrating nursing informatics (NI) into curricula is essential. NI is a specialty that combines nursing science, computer science, and information science to manage health information and improve patient health outcomes (American Nurses Association, 2008). Approximately 98,000 patient deaths per year occur due to…
Smith, James F; Breyer, Benjamin N; Shindel, Alan W
The prevalence and associations of sexual bother in male medical students has not been extensively studied. The aim of this study is to analyze predictors of sexual bother in a survey of male North American medical students. Students enrolled in allopathic and osteopathic medical schools in North America between February 2008 and July 2008 were invited to participate in an internet-based survey of sexuality and sexual function. The principle outcome measure was a single-item question inquiring about global satisfaction with sexual function. The survey also consisted of a questionnaire that included ethnodemographic factors, student status, sexual history, and a validated scale for the assessment of depression. Respondents completed the International Index of Erectile Function, the premature ejaculation diagnostic tool, and the Self-Esteem and Relationship Quality survey (SEAR). Descriptive statistics, analysis of variance, and multivariable logistic regression were utilized to analyze responses. There were 480 male subjects (mean age 26.3 years) with data sufficient for analysis. Forty-three (9%) reported sexual bother. Sexual bother was significantly more common in men with erectile dysfunction (ED), high risk of premature ejaculation (HRPE), depressive symptoms, and lower sexual frequency. However, after multivariate analysis including SEAR scores, ED, and HRPE were no longer independently predictive of sexual bother. Higher scores for all domains of the SEAR were associated with lower odds of sexual bother. ED and HRPE are associated with sexual bother in this young and presumably healthy population. However, after controlling for relationship factors neither ED nor HRPE independently predicted sexual bother. It is plausible to hypothesize that sexual dysfunction from organic causes is rare in this population and is seldom encountered outside of relationship perturbations. Attention to relationship and psychological factors is likely of key importance in
Bellazzi, Riccardo; Diomidous, Marianna; Sarkar, Indra Neil; Takabayashi, Katsuhiko; Ziegler, Andreas; McCray, Alexa T.
Summary Background Medicine and biomedical sciences have become data-intensive fields, which, at the same time, enable the application of data-driven approaches and require sophisticated data analysis and data mining methods. Biomedical informatics provides a proper interdisciplinary context to integrate data and knowledge when processing available information, with the aim of giving effective decision-making support in clinics and translational research. Objectives To reflect on different perspectives related to the role of data analysis and data mining in biomedical informatics. Methods On the occasion of the 50th year of Methods of Information in Medicine a symposium was organized, that reflected on opportunities, challenges and priorities of organizing, representing and analysing data, information and knowledge in biomedicine and health care. The contributions of experts with a variety of backgrounds in the area of biomedical data analysis have been collected as one outcome of this symposium, in order to provide a broad, though coherent, overview of some of the most interesting aspects of the field. Results The paper presents sections on data accumulation and data-driven approaches in medical informatics, data and knowledge integration, statistical issues for the evaluation of data mining models, translational bioinformatics and bioinformatics aspects of genetic epidemiology. Conclusions Biomedical informatics represents a natural framework to properly and effectively apply data analysis and data mining methods in a decision-making context. In the future, it will be necessary to preserve the inclusive nature of the field and to foster an increasing sharing of data and methods between researchers. PMID:22146916
Full Text Available Alejandro Casas,1 Maria Montes de Oca,2 Ana MB Menezes,3 Fernando C Wehrmeister,3 Maria Victorina Lopez Varela,4 Laura Mendoza,5 Larissa Ramírez,6 Marc Miravitlles7 On behalf of the LASSYC team 1Fundación Neumológica Colombiana, Universidad del Rosario, Bogotá, Colombia; 2Universidad Central de Venezuela, Caracas, Venezuela; 3Federal University of Pelotas, Pelotas, Brazil; 4Universidad de la República, Montevideo, Uruguay; 5Hospital Clínico Universidad de Chile, Santiago de Chile, Chile; 6AstraZeneca, San José, Costa Rica; 7Department of Pneumology, Hospital Universitari Vall d’Hebron, CIBER de Enfermedades Respiratorias (CIBERES, Barcelona, Spain Background: Limited information is available regarding medication use in COPD patients from Latin America. This study evaluated the type of medication used and the adherence to different inhaled treatments in stable COPD patients from the Latin American region.Methods: This was an observational, cross-sectional, multinational, and multicenter study in COPD patients attended by specialist doctors from seven Latin American countries. Adherence to inhaled therapy was assessed using the Test of Adherence to Inhalers (TAI questionnaire. The type of medication was assessed as: short-acting β-agonist (SABA or short-acting muscarinic antagonist (SAMA only, long-acting muscarinic antagonist (LAMA, long-acting β-agonist (LABA, LABA/LAMA, inhaled corticosteroid (ICS, ICS/LABA, ICS/LAMA/LABA, or other.Results: In total, 795 patients were included (59.6% male, with a mean age of 69.5±8.7 years and post-bronchodilator FEV1 of 50.0%±18.6%. The ICS/LAMA/LABA (32.9% and ICS/LABA (27.7% combinations were the most common medications used, followed by LABA/LAMA (11.3%, SABA or SAMA (7.9%, LABA (6.4%, LAMA (5.8%, and ICS (4.3%. The types of medication most commonly used in each Global Initiative for Chronic Obstructive Lung Disease (GOLD 2013 category were ICS/LABA (A: 32.7%; B: 19.8%; C: 25.7%; D: 28.2% and
Andrii M. Striuk
Full Text Available Based on the analysis of approaches to the definition of professional competencies of IT students the competence in programming of bachelor of informatics is proposed. Due to the standard of training in 040302 “Informatics” and Computing Curricula 2001 it was defined the content and structure of the competence in programming of bachelor of informatics. The system of content modules providing its formation was designed. The contribution of regulatory competencies of bachelor of informatics in the formation of competence in programming is defined. The directions of formation of competence in programming in the cloudy-oriented learning environment are proposed.
Shirai, Hiroki; Prades, Catherine; Vita, Randi
to the antibody science in every project in antibody drug discovery. Recent experimental technologies allow for the rapid generation of large-scale data on antibody sequences, affinity, potency, structures, and biological functions; this should accelerate drug discovery research. Therefore, a robust bioinformatic...... infrastructure for these large data sets has become necessary. In this article, we first identify and discuss the typical obstacles faced during the antibody drug discovery process. We then summarize the current status of three sub-fields of antibody informatics as follows: (i) recent progress in technologies...... for antibody rational design using computational approaches to affinity and stability improvement, as well as ab-initio and homology-based antibody modeling; (ii) resources for antibody sequences, structures, and immune epitopes and open drug discovery resources for development of antibody drugs; and (iii...
Pereira, Samáris Ramiro; Duarte, Jacy Marcondes; Bandiera-Paiva, Paulo
From the hypothesis that the development of scientific papers, mainly in interdisciplinary areas such as Health Informatics, may bring difficulties to the author, as had its communicative efficacy decreased or compromising their approval for publication; we aim to make considerations on the main items to good players making this kind of text. The scientific writing has peculiarities that must be taken into consideration when it writes: general characteristics, such as simplicity and objectivity, and characteristics of each area of knowledge, such as terminology, formatting and standardization. The research methodology adopted is bibliographical. The information was based on literature review and the authors' experience, teachers and assessors of scientific methodology in peer review publications in the area. As a result, we designed a checklist of items to be checked before submission of a paper to a scientific publication vehicle in order to contribute to the promotion of research, facilitating the publication and increase its capacity in this important area of knowledge.
Scott J. N McNabb
Full Text Available Over the past decade, the world has radically changed. New advances in information and communication technologies (ICT connect the world in ways never imagined. Public health informatics (PHI leveraged for public health surveillance (PHS, can enable, enhance, and empower essential PHS functions (i.e., detection, reporting, confirmation, analyses, feedback, response. However, the tail doesn't wag the dog; as such, ICT cannot (should not drive public health surveillance strengthening. Rather, ICT can serve PHS to more effectively empower core functions. In this review, we explore promising ICT trends for prevention, detection, and response, laboratory reporting, push notification, analytics, predictive surveillance, and using new data sources, while recognizing that it is the people, politics, and policies that most challenge progress for implementation of solutions.
Martin-Sanchez, F; Maojo, V
To analyze the role that biomedical informatics could play in the application of the NBIC Converging Technologies in the medical field and raise awareness of these new areas throughout the Biomedical Informatics community. Review of the literature and analysis of the reference documents in this domain from the biomedical informatics perspective. Detailing existing developments showing that partial convergence of technologies have already yielded relevant results in biomedicine (such as bioinformatics or biochips). Input from current projects in which the authors are involved is also used. Information processing is a key issue in enabling the convergence of NBIC technologies. Researchers in biomedical informatics are in a privileged position to participate and actively develop this new scientific direction. The experience of biomedical informaticians in five decades of research in the medical area and their involvement in the completion of the Human and other genome projects will help them participate in a similar role for the development of applications of converging technologies -particularly in nanomedicine. The proposed convergence will bring bridges between traditional disciplines. Particular attention should be placed on the ethical, legal, and social issues raised by the NBIC convergence. These technologies provide new directions for research and education in Biomedical Informatics placing a greater emphasis in multidisciplinary approaches.
Gaona, E.; Huitron, B.G.
This book composes the works received for the 1st Ibero-Latin American and the Caribbean Congress on Medical Physics. There are 68 works which represent a sample of the recent advances of the medical physics which are indicators about the level of development of the speciality in these regions of the world. Thus, the Congress represents the greatest event of medical physics of Ibero-Latin America and the Caribbean besides its consolidation and regional organization. The book also contains useful counsels for the education, yours researches and the daily hospitable practice. (Author)
.... Amsterdam: lOS Press, Studies in Health Technology and Informatics 1997; 42, with permission. This book is printed on acid-free paper. (~ Copyright 92006, Elsevier Inc. All rights reserved. No part ...
Gennady N. Zverev
Full Text Available This paper defines the goals and problems of fundamental informatics, formulates principal laws of information universe and constructive bases of information objects and processes. The classification of semantics types of knowledge and skills is presented.
Magnuson, J A
In a revised edition, this book covers all aspects of public health informatics, and discusses the creation and management of an information technology infrastructure that is essential in linking state and local organizations in their efforts to gather data.
The International Academy of Health Sciences Informatics (IAHSI) is established by International Medical Informatics Association (IMIA) which is the world body for health and biomedical informatics. The Academy will serve as an honor society that recognizes expertise in biomedical and health informatics internationally. Academy membership will be one of the highest honors in the international field of biomedical and health informatics. To present scientometric analysis of founding members of the International Academy of Health Sciences Informatics, to evaluate members and their scientific rating. The work has an analytical character and presents analysis of the data obtained from the Google Scholar and Scopus database. Results are shown through number of cases, percentage and graphically. The analysis showed a significant correlation between the Academy and the country (continent) of origin of the academician. In IAHSI are mainly represented academics originating from Europe - 40 members (33,3%), North America - 39 members (32,5%), Asia - 20 members (16,6%), South America - 9 members (7,5%), Australia - 7 members (5,8%), while only 5 members or 4,16% come from Africa. Criteria for number of representatives of each continent to main academic communities are relatively questionable, as this analysis showed. Development of Health Sciences Informatics should be the main purpose, and it should be evenly distributed with slight deviations in number of representatives of each continent.
Michael P. Wilson
Full Text Available Introduction: The emergency medical evaluation of psychiatric patients presenting to United States emergency departments (ED, usually termed “medical clearance,” often varies between EDs. A task force of the American Association for Emergency Psychiatry (AAEP, consisting of physicians from emergency medicine, physicians from psychiatry and a psychologist, was convened to form consensus recommendations for the medical evaluation of psychiatric patients presenting to U.S.EDs. Methods: The task force reviewed existing literature on the topic of medical evaluation of psychiatric patients in the ED and then combined this with expert consensus. Consensus was achieved by group discussion as well as iterative revisions of the written document. The document was reviewed and approved by the AAEP Board of Directors. Results: Eight recommendations were formulated. These recommendations cover various topics in emergency medical examination of psychiatric patients, including goals of medical screening in the ED, the identification of patients at low risk for co-existing medical disease, key elements in the ED evaluation of psychiatric patients including those with cognitive disorders, specific language replacing the term “medical clearance,” and the need for better science in this area. Conclusion: The evidence indicates that a thorough history and physical examination, including vital signs and mental status examination, are the minimum necessary elements in the evaluation of psychiatric patients. With respect to laboratory testing, the picture is less clear and much more controversial.
Wilson, Michael P; Nordstrom, Kimberly; Anderson, Eric L; Ng, Anthony T; Zun, Leslie S; Peltzer-Jones, Jennifer M; Allen, Michael H
The emergency medical evaluation of psychiatric patients presenting to United States emergency departments (ED), usually termed "medical clearance," often varies between EDs. A task force of the American Association for Emergency Psychiatry (AAEP), consisting of physicians from emergency medicine, physicians from psychiatry and a psychologist, was convened to form consensus recommendations for the medical evaluation of psychiatric patients presenting to U.S.EDs. The task force reviewed existing literature on the topic of medical evaluation of psychiatric patients in the ED and then combined this with expert consensus. Consensus was achieved by group discussion as well as iterative revisions of the written document. The document was reviewed and approved by the AAEP Board of Directors. Eight recommendations were formulated. These recommendations cover various topics in emergency medical examination of psychiatric patients, including goals of medical screening in the ED, the identification of patients at low risk for co-existing medical disease, key elements in the ED evaluation of psychiatric patients including those with cognitive disorders, specific language replacing the term "medical clearance," and the need for better science in this area. The evidence indicates that a thorough history and physical examination, including vital signs and mental status examination, are the minimum necessary elements in the evaluation of psychiatric patients. With respect to laboratory testing, the picture is less clear and much more controversial.
Andrew M Quinn
Full Text Available The Partners HealthCare system′s Clinical Fellowship in Pathology Informatics (Boston, MA, USA faces ongoing challenges to the delivery of its core curriculum in the forms of: (1 New classes of fellows annually with new and varying educational needs and increasingly fractured, enterprise-wide commitments; (2 taxing electronic health record (EHR and laboratory information system (LIS implementations; and (3 increasing interest in the subspecialty at the academic medical centers (AMCs in what is a large health care network. In response to these challenges, the fellowship has modified its existing didactic sessions and piloted both a network-wide pathology informatics lecture series and regular "learning laboratories". Didactic sessions, which had previously included more formal discussions of the four divisions of the core curriculum: Information fundamentals, information systems, workflow and process, and governance and management, now focus on group discussions concerning the fellows′ ongoing projects, updates on the enterprise-wide EHR and LIS implementations, and directed questions about weekly readings. Lectures are given by the informatics faculty, guest informatics faculty, current and former fellows, and information systems members in the network, and are open to all professional members of the pathology departments at the AMCs. Learning laboratories consist of small-group exercises geared toward a variety of learning styles, and are driven by both the fellows and a member of the informatics faculty. The learning laboratories have created a forum for discussing real-time and real-world pathology informatics matters, and for incorporating awareness of and timely discussions about the latest pathology informatics literature. These changes have diversified the delivery of the fellowship′s core curriculum, increased exposure of faculty, fellows and trainees to one another, and more equitably distributed teaching responsibilities among
Quinn, Andrew M; Klepeis, Veronica E; Mandelker, Diana L; Platt, Mia Y; Rao, Luigi K F; Riedlinger, Gregory; Baron, Jason M; Brodsky, Victor; Kim, Ji Yeon; Lane, William; Lee, Roy E; Levy, Bruce P; McClintock, David S; Beckwith, Bruce A; Kuo, Frank C; Gilbertson, John R
The Partners HealthCare system's Clinical Fellowship in Pathology Informatics (Boston, MA, USA) faces ongoing challenges to the delivery of its core curriculum in the forms of: (1) New classes of fellows annually with new and varying educational needs and increasingly fractured, enterprise-wide commitments; (2) taxing electronic health record (EHR) and laboratory information system (LIS) implementations; and (3) increasing interest in the subspecialty at the academic medical centers (AMCs) in what is a large health care network. In response to these challenges, the fellowship has modified its existing didactic sessions and piloted both a network-wide pathology informatics lecture series and regular "learning laboratories". Didactic sessions, which had previously included more formal discussions of the four divisions of the core curriculum: Information fundamentals, information systems, workflow and process, and governance and management, now focus on group discussions concerning the fellows' ongoing projects, updates on the enterprise-wide EHR and LIS implementations, and directed questions about weekly readings. Lectures are given by the informatics faculty, guest informatics faculty, current and former fellows, and information systems members in the network, and are open to all professional members of the pathology departments at the AMCs. Learning laboratories consist of small-group exercises geared toward a variety of learning styles, and are driven by both the fellows and a member of the informatics faculty. The learning laboratories have created a forum for discussing real-time and real-world pathology informatics matters, and for incorporating awareness of and timely discussions about the latest pathology informatics literature. These changes have diversified the delivery of the fellowship's core curriculum, increased exposure of faculty, fellows and trainees to one another, and more equitably distributed teaching responsibilities among the entirety of the
Baicu, Floarea; Baches, Maria Alexandra
In this paper are presented methods of impact analysis on informatics system security accidents, qualitative and quantitative methods, starting with risk and informational system security definitions. It is presented the relationship between the risks of exploiting vulnerabilities of security system, security level of these informatics systems, probability of exploiting the weak points subject to financial losses of a company, respectively impact of a security accident on the company. Herewit...
This book deals with research and development and industrial informatization with development of technology international trend, the present conditions of scientific technology in the major nations, politics of technical development and trend, process of national research and development, research for industrial research and development, strengthen cooperation for scientific technology among nations, current situation and development of technology by field such as energy, software and system, and technology for industrial informatization.
The Intelligent Systems Series comprises titles that present state of the art knowledge and the latest advances in intelligent systems. Its scope includes theoretical studies, design methods, and real-world implementations and applications. Traditionally, Intelligence and Security Informatics (ISI) research and applications have focused on information sharing and data mining, social network analysis, infrastructure protection and emergency responses for security informatics. With the continuous advance of IT technologies and the increasing sophistication of national and international securi
Rahal, Boushra; Mansour, Nabil; Zaatari, Ghazi
The American University of Beirut Faculty of Medicine (AUB-FM) strategy is to develop faculty members (fm) skills by sponsoring local and international scientific activities has been in place for over three decades, and remains dependent on individuals' efforts. In 2011-2012, Faculty Development Program (FDP) was introduced to develop faculty leadership, business skills in medicine, fulfill personal and professional goals, followed by a five-year plan to cover five themes: Management/Leadership, Marketing, Finance, Strategic Planning and Communications with the purpose of integrating these themes in medical practice. A survey was sent to all departments at AUB-FM in 2011 to assess needs and determine themes. Nine workshops were conducted, followed by post-workshop evaluation. 117 fm responded to needs assessment surveys. Respondents had on average 15 years in clinical practice, 50% with extensive to moderate administrative experience; 71% assumed administrative responsibilities at least once, 56% in leadership positions. Faculty attendance dropped midway from 69 to 19, although workshops were rated very good to excellent. Although faculty were interested in FDP, the drop in attendance might be attributed to: challenges to achieve personal and professional goals while struggling to fulfill their roles, satisfy promotion requirements and generate their income. FDP has to be aligned with FM strategic goals and faculty objectives, be complimentary to a faculty mentoring program, provide rewards, and be supported by a faculty progression tool.
Kenny, Stephen C
Prior to the American Civil War, museums were enthusiastically promoted in the annual circulars of southern medical colleges as valuable aids to medical education. Using case history narratives, medical college circulars, and announcements, this article examines the social origins of the region's collections of anatomical and pathological specimens and explores the professional agents and organizations responsible for their maintenance and development. The article is also concerned with exploring the racial framework in which these bodies and specimens were sourced and displayed. The social relations embodied in natural history and medical museum collections, and the emerging specialism of "negro medicine," were all elements of a context that subordinated and objectified blackness, as well as permitting and legitimizing the exploitation of black bodies. Medical museums function as a key case study for examining power relations among physicians, slaves, and slave owners, as well as underscoring southern medicine's dependence on slavery for its development.
Jenkins, Carol G; Bader, Shelley A
The Association of Academic Health Sciences Libraries has made collaboration with other organizations a fundamental success strategy throughout its twenty-five year history. From the beginning its relationships with Association of American Medical Colleges and with the Medical Library Association have shaped its mission and influenced its success at promoting academic health sciences libraries' roles in their institutions. This article describes and evaluates those relationships. It also describes evolving relationships with other organizations including the National Library of Medicine and the Association of Research Libraries.
Chennubhotla, C; Clarke, L P; Fedorov, A; Foran, D; Harris, G; Helton, E; Nordstrom, R; Prior, F; Rubin, D; Saltz, J H; Shalley, E; Sharma, A
Objectives: Precision medicine requires the measurement, quantification, and cataloging of medical characteristics to identify the most effective medical intervention. However, the amount of available data exceeds our current capacity to extract meaningful information. We examine the informatics needs to achieve precision medicine from the perspective of quantitative imaging and oncology. Methods: The National Cancer Institute (NCI) organized several workshops on the topic of medical imaging and precision medicine. The observations and recommendations are summarized herein. Results: Recommendations include: use of standards in data collection and clinical correlates to promote interoperability; data sharing and validation of imaging tools; clinician's feedback in all phases of research and development; use of open-source architecture to encourage reproducibility and reusability; use of challenges which simulate real-world situations to incentivize innovation; partnership with industry to facilitate commercialization; and education in academic communities regarding the challenges involved with translation of technology from the research domain to clinical utility and the benefits of doing so. Conclusions: This article provides a survey of the role and priorities for imaging informatics to help advance quantitative imaging in the era of precision medicine. While these recommendations were drawn from oncology, they are relevant and applicable to other clinical domains where imaging aids precision medicine. Georg Thieme Verlag KG Stuttgart.
Haux, R; Lehmann, C U
In 2009, Applied Clinical Informatics (ACI)--focused on applications in clinical informatics--was launched as a companion journal to Methods of Information in Medicine (MIM). Both journals are official journals of the International Medical Informatics Association. To explore which congruencies and interdependencies exist in publications from theory to practice and from practice to theory and to determine existing gaps. Major topics discussed in ACI and MIM were analyzed. We explored if the intention of publishing companion journals to provide an information bridge from informatics theory to informatics practice and vice versa could be supported by this model. In this manuscript we will report on congruencies and interdependences from practice to theory and on major topics in MIM. Retrospective, prolective observational study on recent publications of ACI and MIM. All publications of the years 2012 and 2013 were indexed and analyzed. Hundred and ninety-six publications were analyzed (ACI 87, MIM 109). In MIM publications, modelling aspects as well as methodological and evaluation approaches for the analysis of data, information, and knowledge in biomedicine and health care were frequently raised - and often discussed from an interdisciplinary point of view. Important themes were ambient-assisted living, anatomic spatial relations, biomedical informatics as scientific discipline, boosting, coding, computerized physician order entry, data analysis, grid and cloud computing, health care systems and services, health-enabling technologies, health information search, health information systems, imaging, knowledge-based decision support, patient records, signal analysis, and web science. Congruencies between journals could be found in themes, but with a different focus on content. Interdependencies from practice to theory, found in these publications, were only limited. Bridging from informatics theory to practice and vice versa remains a major component of successful
Ashrafi, Noushin; Kuilboer, Jean-Pierre; Joshi, Chaitanya; Ran, Iris; Pande, Priyanka
The explosive advances in information technology combined with the current climate for health care reform have intensified the need for skilled individuals who can develop, understand, and manage medical information systems in organizations. Health Informatics facilitates quality care at a reasonable cost by allowing access to the right data by…
When comic books rose to mass popularity in the early 1940s, one segment of the industry specialized in "true adventures," with stories about real people from the past and the present--in contrast to competing books that offered fantasy, science fiction, superheroes, detectives and crime, funny people, or funny animals. This study examines the figures from both medical history and twentieth-century medicine who were portrayed as heroes and role models in these comic books: first, to call attention to this very popular, if unknown, genre of medical history, and second, to illustrate how medical history was used at that time to popularize scientific and medical ideas, to celebrate the achievements of medical research, to encourage medical science as a career choice, and to show medicine as a humane and noble enterprise. The study explains how these medical history stories were situated in American popular culture more generally, and how the graphic power of comic books successfully conveyed both values and information while also telling a good story. Attention to this colorful genre of popular medical history enriches our picture of the mid-twentieth-century public's enthusiasm for medical progress.
Johnson, S B
Objectives: The primary goal of this review is to summarize significant developments in the field of Clinical Research Informatics (CRI) over the years 2015-2016. The secondary goal is to contribute to a deeper understanding of CRI as a field, through the development of a strategy for searching and classifying CRI publications. Methods: A search strategy was developed to query the PubMed database, using medical subject headings to both select and exclude articles, and filtering publications by date and other characteristics. A manual review classified publications using stages in the "research study lifecycle", with key stages that include study definition, participant enrollment, data management, data analysis, and results dissemination. Results: The search strategy generated 510 publications. The manual classification identified 125 publications as relevant to CRI, which were classified into seven different stages of the research lifecycle, and one additional class that pertained to multiple stages, referring to general infrastructure or standards. Important cross-cutting themes included new applications of electronic media (Internet, social media, mobile devices), standardization of data and procedures, and increased automation through the use of data mining and big data methods. Conclusions: The review revealed increased interest and support for CRI in large-scale projects across institutions, regionally, nationally, and internationally. A search strategy based on medical subject headings can find many relevant papers, but a large number of non-relevant papers need to be detected using text words which pertain to closely related fields such as computational statistics and clinical informatics. The research lifecycle was useful as a classification scheme by highlighting the relevance to the users of clinical research informatics solutions. Georg Thieme Verlag KG Stuttgart.
Ramar, Kannan; Rosen, Ilene M; Kirsch, Douglas B; Chervin, Ronald D; Carden, Kelly A; Aurora, R Nisha; Kristo, David A; Malhotra, Raman K; Martin, Jennifer L; Olson, Eric J; Rosen, Carol L; Rowley, James A
The diagnosis and effective treatment of obstructive sleep apnea (OSA) in adults is an urgent health priority. Positive airway pressure (PAP) therapy remains the most effective treatment for OSA, although other treatment options continue to be explored. Limited evidence citing small pilot or proof of concept studies suggest that the synthetic medical cannabis extract dronabinol may improve respiratory stability and provide benefit to treat OSA. However, side effects such as somnolence related to treatment were reported in most patients, and the long-term effects on other sleep quality measures, tolerability, and safety are still unknown. Dronabinol is not approved by the United States Food and Drug Administration (FDA) for treatment of OSA, and medical cannabis and synthetic extracts other than dronabinol have not been studied in patients with OSA. The composition of cannabinoids within medical cannabis varies significantly and is not regulated. Synthetic medical cannabis may have differential effects, with variable efficacy and side effects in the treatment of OSA. Therefore, it is the position of the American Academy of Sleep Medicine (AASM) that medical cannabis and/or its synthetic extracts should not be used for the treatment of OSA due to unreliable delivery methods and insufficient evidence of effectiveness, tolerability, and safety. OSA should be excluded from the list of chronic medical conditions for state medical cannabis programs, and patients with OSA should discuss their treatment options with a licensed medical provider at an accredited sleep facility. Further research is needed to understand the functionality of medical cannabis extracts before recommending them as a treatment for OSA. Copyright © 2018 American Academy of Sleep Medicine. All rights reserved.
Tang, Jennifer Y; Li, Chieh; Rodgers, Rachel F; Ballou, Mary
Several meta-analyses have demonstrated the effectiveness of treatment utilizing cognitive behavioral therapy (CBT) combined with medication. There is, however, a paucity of research comparing the effectiveness of this combined treatment with psychiatric patients from different ethnic backgrounds. This study is the first of its kind to compare the effectiveness of CBT combined with medication for Asian American and White patients' psychiatric symptom severity levels of depression, anxiety, psychological well-being, and quality of life. The study examined the effects of CBT combined with medication for 43 Asian American and 43 White Non-Hispanic patients at an acute psychiatric partial hospital. A 2×2 between-within repeated measures analysis of variance was used. Results indicated significant improvement after treatment in all symptom categories assessed for the Asian American and White patients. The findings displayed trends over the course of treatment toward a greater decrease in anxiety symptoms among Asian patients but a larger increase in functioning level among White patients. In conclusion, the findings from this study provide preliminary cross-cultural support for CBT combined with medication as a treatment in partial hospital settings and suggest that the effectiveness of such treatments is similar across cultural groups. Copyright © 2016. Published by Elsevier B.V.
Full Text Available The present article describes the informatization process of a hospital service, taking as an example the implementation of a prescription writing software. This tool allows doctors to prescribe via computer the pharmaceutical regimen to be prepared and dispensed by the nursing personnel. The ethnographic study in the hospital service describes the introduction process of this tool from the perspective of the daily activities of the nursing staff. The article highlights a number of difficulties the users are facing and describes the solutions they create, in particular the “compensation strategies” they develop for turning the tool operational, reliable and efficient. The article also shows that the compensation strategies the users are creating in situ are partly invisible for the designers of the software. Distant from the daily activities of the users, the software designers neither perceive the problems involved with the use of the product, nor do they perceive the locally created solutions. They ascribe the performance of the tool to the quality of its conception and possibilities of improvement. This article invites the readers to reflect about what turns an information system efficient and effective and about the lessons learned for the conception of these tools.
Borne, K. D.
The discipline of data science is merging with multiple science disciplines to form new X-informatics research disciplines. They are almost too numerous to name, but they include geoinformatics, bioinformatics, cheminformatics, biodiversity informatics, ecoinformatics, materials informatics, and the emerging discipline of astroinformatics. Within any X-informatics discipline, the information granules are unique to that discipline -- e.g., gene sequences in bio, the sky object in astro, and the spatial object in geo (such as points, lines, and polygons in the vector model, and pixels in the raster model). Nevertheless the goals are similar: transparent data re-use across subdisciplines and within education settings, information and data integration and fusion, personalization of user interactions with the data collection, semantic search and retrieval, and knowledge discovery. The implementation of an X-informatics framework enables these semantic e-science research goals. We describe the concepts, challenges, and new developments associated with the new discipline of astroinformatics, and how geoinformatics provides valuable lessons learned and a model for practical semantic science within a traditional science discipline through the accretion of data science methodologies (such as formal metadata creation, data models, data mining, information retrieval, knowledge engineering, provenance, taxonomies, and ontologies). The emerging concept of data-as-a-service (DaaS) builds upon the concept of smart data (or data DNA) for intelligent data management, automated workflows, and intelligent processing. Smart data, defined through X-informatics, enables several practical semantic science use cases, including self-discovery, data intelligence, automatic recommendations, relevance analysis, dimension reduction, feature selection, constraint-based mining, interdisciplinary data re-use, knowledge-sharing, data use in education, and more. We describe these concepts within the
Lapane, Kate L; Cameron, Kathleen; Feinberg, Janice
.... While clinical informatics systems have focused on the reduction of medication errors at the point of prescribing, dispensing, or administration, few have proposed the use of information technology...
Gee, Gilbert C; Delva, Jorge; Takeuchi, David T
We examined associations between self-reported unfair treatment and prescription medication use, illicit drug use, and alcohol dependence. We used data from the Filipino American Community Epidemiological Survey, a cross-sectional investigation involving 2217 Filipino Americans interviewed in 1998-1999. Multinomial logistic and negative binomial regression analyses were used in assessing associations between unfair treatment and the substance use categories. Reports of unfair treatment were associated with prescription drug use, illicit drug use, and alcohol dependence after control for age, gender, location of residence, employment status, educational level, ethnic identity level, nativity, language spoken, marital status, and several health conditions. Unfair treatment may contribute to illness and subsequent use of prescription medications. Furthermore, some individuals may use illicit drugs and alcohol to cope with the stress associated with such treatment. Addressing the antecedents of unfair treatment may be a potential intervention route.
Cesnik, Branko; Kidd, Michael R
In considering a 'history' of Health Informatics it is important to be aware that the discipline encompasses a wide array of activities, products, research and theories. Health Informatics is as much a result of evolution as planned philosophy, having its roots in the histories of information technology and medicine. The process of its growth continues so that today's work is tomorrow's history. A 'historical' discussion of the area is its history to date, a report rather than a summation. As well as its successes, the history of Health Informatics is populated with visionary promises that have failed to materialise despite the best intentions. For those studying the subject or working in the field, the experiences of others' use of Information Technologies for the betterment of health care can provide a necessary perspective. This chapter starts by noting some of the major events and people that form a technological backdrop to Health Informatics and ends with some thoughts on the future. This chapter gives an educational overview of: * The history of computing * The beginnings of the health informatics discipline.
Full Text Available Recent advances in automated high-resolution fluorescence microscopy and robotic handling have made the systematic and cost effective study of diverse morphological changes within a large population of cells possible under a variety of perturbations, e.g., drugs, compounds, metal catalysts, RNA interference (RNAi. Cell population-based studies deviate from conventional microscopy studies on a few cells, and could provide stronger statistical power for drawing experimental observations and conclusions. However, it is challenging to manually extract and quantify phenotypic changes from the large amounts of complex image data generated. Thus, bioimage informatics approaches are needed to rapidly and objectively quantify and analyze the image data. This paper provides an overview of the bioimage informatics challenges and approaches in image-based studies for drug and target discovery. The concepts and capabilities of image-based screening are first illustrated by a few practical examples investigating different kinds of phenotypic changes caEditorsused by drugs, compounds, or RNAi. The bioimage analysis approaches, including object detection, segmentation, and tracking, are then described. Subsequently, the quantitative features, phenotype identification, and multidimensional profile analysis for profiling the effects of drugs and targets are summarized. Moreover, a number of publicly available software packages for bioimage informatics are listed for further reference. It is expected that this review will help readers, including those without bioimage informatics expertise, understand the capabilities, approaches, and tools of bioimage informatics and apply them to advance their own studies.
AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS, AMERICAN COLLEGE OF ENDOCRINOLOGY, AND ASSOCIAZIONE MEDICI ENDOCRINOLOGI MEDICAL GUIDELINES FOR CLINICAL PRACTICE FOR THE DIAGNOSIS AND MANAGEMENT OF THYROID NODULES - 2016 UPDATE
Gharib, Hossein; Papini, Enrico; Garber, Jeffrey R
by the American Association of Clinical Endocrinologists (AACE), American College of Endocrinology (ACE) and Associazione Medici Endocrinologi (AME). ABBREVIATIONS: AACE = American Association of Clinical Endocrinologists ACE = American College of Endocrinology AME = Associazione Medici Endocrinologi BEL = best...
Full Text Available Actual philosophical and scientifically methodological problems of modern Informatics as fundamental science and a complex scientific direction are considered. Communication of these problems with prospects of development of Informatics and fundamental science as a whole is shown.
U.S. Department of Health & Human Services — The Federal Interagency Traumatic Brain Injury Research (FITBIR) informatics system is an extensible, scalable informatics platform for TBI relevant imaging,...
Ko, Linda K; Taylor, Victoria M; Yoon, Jihye; Copeland, Wade K; Hwang, Joo Ha; Lee, Eun Jeong; Inadomi, John
Colorectal cancer (CRC) remains the most commonly diagnosed cancer among Korean Americans (KAs) in part due to low screening rates. Recent studies suggest that some KA patients engage in medical tourism and receive medical care in their home country. The impact of medical tourism on CRC screening is unknown. The purpose of this paper was to 1) investigate the frequency of medical tourism, 2) examine the association between medical tourism and CRC screening, and 3) characterize KA patients who engage in medical tourism. This is a community-based, cross-sectional study involving self-administered questionnaires conducted from August 2013 to October 2013. Data was collected on 193 KA patients, ages 50-75, residing in the Seattle metropolitan area. The outcome variable is up-to-date with CRC screening, defined as having had a stool test (Fecal Occult Blood Test or Fecal Immunochemical Test) within the past year or a colonoscopy within 10 years. Predictor variables are socio-demographics, health factors, acculturation, knowledge, financial concerns for medical care costs, and medical tourism. In multi-variate modeling, medical tourism was significantly related to being up-to-date with CRC screening. Participants who engaged in medical tourism had 8.91 (95% CI: 3.89-23.89) greater odds of being up-to-date with CRC screening compared to those who did not travel for healthcare. Factors associated with engaging in medical tourism were lack of insurance coverage (P = 0.008), higher levels of education (P = 0.003), not having a usual place of care (P = 0.002), older age at immigration (P = 0.009), shorter years-of-stay in the US (P = 0.003), and being less likely to speak English well (P = 0.03). This study identifies the impact of medical tourism on CRC screening and characteristics of KA patients who report engaging in medical tourism. Healthcare providers in the US should be aware of the customary nature of medical tourism among KAs and consider
Valverde, Nelson; Cardenas, Juan; Perez, Maria del Rosario; Trano, Jose Luiz Di; Gisone, Pablo
The objective of this program is to have a system, in order to assure an appropriate medical response in the case of radiological accidents and to offer medical advice in aspects related to the biological effects of ionizing radiations in risk assessment of radiation workers, medical exposures, potential effects of prenatal irradiation
Conclusions: Cultural differences affect students' perception of their studies, mentors and future careers. Medical educators should be sensitive to the effects of students' background which influence academic and professional attitudes and find ways to strengthen their commitment to the profession.
Full Text Available Even though informatics is a term used commonly in healthcare, it can be a confusing and disengaging one. Many definitions exist in the literature, and attempts have been made to develop a clear taxonomy. Despite this, informatics is still a term that lacks clarity in both its scope and the classification of sub-terms that it encompasses.This paper reviews the importance of an agreed taxonomy and explores the challenges of establishing exactly what is meant by health informatics (HI. It reviews what a taxonomy should do, summarises previous attempts at categorising and organising HI and suggests the elements to consider when seeking to develop a system of classification.The paper does not provide all the answers, but it does clarify the questions. By plotting a path towards a taxonomy of HI, it will be possible to enhance understanding and optimise the benefits of embracing technology in clinical practice.
Ольга Юрьевна Заславская
Full Text Available This article describes the requirements for the training of teachers of Informatics, the need for managerial competence. Recommendations to the teacher of Informatics for the attestation of pedagogical staff.
NREL Decision Science and Informatics Energy Decision Science and Informatics NREL utilizes and advances state-of-the-art decision science and informatics to help partners make well-informed energy decisions backed by credible, objective data analysis and insights to maximize the impact of energy
Pardalos, Panos M; Xanthopoulos, Petros
This volume covers some of the topics that are related to the rapidly growing field of biomedical informatics. In June 11-12, 2010 a workshop entitled 'Optimization and Data Analysis in Biomedical Informatics' was organized at The Fields Institute. Following this event invited contributions were gathered based on the talks presented at the workshop, and additional invited chapters were chosen from world's leading experts. In this publication, the authors share their expertise in the form of state-of-the-art research and review chapters, bringing together researchers from different disciplines
Wright, James R; Baskin, Leland B
Historical research on pathology and laboratory medicine services in World War I has been limited. In the Spanish American War, these efforts were primarily focused on tropical diseases. World War I problems that could be addressed by pathology and laboratory medicine were strikingly different because of the new field of clinical pathology. Geographic differences, changing war tactics, and trench warfare created new issues. To describe the scope of pathology and laboratory medicine services in World War I and the value these services brought to the war effort. Available primary and secondary sources related to American Expeditionary Forces' laboratory services were analyzed and contrasted with the British and German approaches. The United States entered the war in April 1917. Colonel Joseph Siler, MD, a career medical officer, was the director, and Colonel Louis B. Wilson, MD, head of pathology at the Mayo Clinic, was appointed assistant director of the US Army Medical Corps Division of Laboratories and Infectious Disease, based in Dijon, France. During the next year, they organized 300 efficient laboratories to support the American Expeditionary Forces. Autopsies were performed to better understand treatment of battlefield injuries, effects of chemical warfare agents, and the influenza pandemic; autopsies also generated teaching specimens for the US Army Medical Museum. Bacteriology services focused on communicable diseases. Laboratory testing for social diseases was very aggressive. Significant advances in blood transfusion techniques, which allowed brief blood storage, occurred during the war but were not primarily overseen by laboratory services. Both Siler and Wilson received Distinguished Service Medals. Wilson's vision for military pathology services helped transform American civilian laboratory services in the 1920s.
Lehmann, C U; Haux, R
In 2009, the journal Applied Clinical Informatics (ACI) commenced publication. Focused on applications in clinical informatics, ACI was intended to be a companion journal to METHODS of Information in Medicine (MIM). Both journals are official journals of IMIA, the International Medical Informatics Association. To explore, after five years, which congruencies and interdependencies exist in publications of these journals and to determine if gaps exist. To achieve this goal, major topics discussed in ACI and in MIM had to be analysed. Finally, we wanted to explore, whether the intention of publishing these companion journals to provide an information bridge from informatics theory to informatics practice and from practice to theory could be supported by this model. In this manuscript we will report on congruencies and interdependencies from practise to theory and on major topis in ACI. Further results will be reported in a second paper. Retrospective, prolective observational study on recent publications of ACI and MIM. All publications of the years 2012 and 2013 from these journals were indexed and analysed. Hundred and ninety-six publications have been analysed (87 ACI, 109 MIM). In ACI publications addressed care coordination, shared decision support, and provider communication in its importance for complex patient care and safety and quality. Other major themes included improving clinical documentation quality and efficiency, effectiveness of clinical decision support and alerts, implementation of health information technology systems including discussion of failures and succeses. An emerging topic in the years analyzed was a focus on health information technology to predict and prevent hospital admissions and managing population health including the application of mobile health technology. Congruencies between journals could be found in themes, but with different focus in its contents. Interdependencies from practise to theory found in these publications, were
Moskowitz, Gordon B; Stone, Jeff; Childs, Amanda
We investigated whether stereotypes unconsciously influence the thinking and behavior of physicians, as they have been shown to do in other professional settings, such as among law enforcement personnel and teachers. We conducted 2 studies to examine whether stereotypes are implicitly activated in physicians. Study 1 assessed what diseases and treatments doctors associate with African Americans. Study 2 presented these (and control terms) to doctors as part of a computerized task. Subliminal images of African American and White men appeared prior to each word, and reaction times to words were recorded. When primed with an African American face, doctors reacted more quickly for stereotypical diseases, indicating an implicit association of certain diseases with African Americans. These comprised not only diseases African Americans are genetically predisposed to, but also conditions and social behaviors with no biological association (e.g., obesity, drug abuse). We found implicit stereotyping among physicians; faces they never consciously saw altered performance. This suggests that diagnoses and treatment of African American patients may be biased, even in the absence of the practitioner's intent or awareness.
Villwock, Jennifer A.; Sobin, Lindsay B.; Koester, Lindsey A.; Harris, Tucker M.
Objectives To describe levels of burnout and impostor syndrome (IS) in medical students, and to recognize demographic differences in those experiencing burnout and IS. Methods Research participants included 2,612 medical students who entered Jefferson Medical College between 2002 and 2012. This sample was divided into two groups: Matriculants between 2002 and 2007 (n=1,380) and between 2008 and 2012 (n=1,232). Data for 2002-2007 matriculants were subjected to EFA (principal component factor e...
Wessel, C; Spreckelsen, C
Problem- and project-based learning are approved methods to train students, graduates and post-graduates in scientific and other professional skills. The students are trained on realistic scenarios in a broader context. For students specializing in health informatics we introduced continued multidisciplinary project-based learning (CM-PBL) at a department of medical informatics. The training approach addresses both students of medicine and students of computer science. The students are full members of an ongoing research project and develop a project-related application or module, or explore or evaluate a sub-project. Two teachers guide and review the students' work. The training on scientific work follows a workflow with defined milestones. The team acts as peer group. By participating in the research team's work the students are trained on professional skills. A research project on a web-based information system on hospitals built the scenario for the realistic context. The research team consisted of up to 14 active members at a time, who were scientists and students of computer science and medicine. The well communicated educational approach and team policy fostered the participation of the students. Formative assessment and evaluation showed a considerable improvement of the students' skills and a high participant satisfaction. Alternative education approaches such as project-based learning empower students to acquire scientific knowledge and professional skills, especially the ability of life-long learning, multidisciplinary team work and social responsibility.
Cipriano, Sarah D; Dybbro, Eric; Boscardin, Christy K; Shinkai, Kanade; Berger, Timothy G
Multiple studies have shown that both current and future primary care providers have insufficient education and training in dermatology. To address the limitations and wide variability in medical student dermatology instruction, the American Academy of Dermatology (AAD) created a standardized, online curriculum for both dermatology learners and educators. We sought to determine the impact of the integration of the AAD online curriculum into a 2-week introductory dermatology clerkship for fourth-year medical students. In addition to their clinical duties, we assigned 18 online modules at a rate of 1 to 3 per day. We evaluated knowledge acquisition using a 50-item, multiple-choice pretest and posttest. Postmodule and end-of-course questionnaires contained both closed and open-ended items soliciting students' perceptions about usability and satisfaction. All 51 participants significantly improved in their dermatology knowledge (P dermatology clerkship. Without a control group who did not experience the online curriculum, we are unable to isolate the specific impact of the online modules on students' learning. This study demonstrates the successful integration of this educational resource into a 2-week, university-based dermatology clerkship. Students' perceptions regarding usability and satisfaction were overwhelmingly positive, suggesting that the online curriculum is highly acceptable to learners. Widespread use of this curriculum may be a significant advancement in standardized dermatology learning for medical students. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.
The purpose of the International Conference on Health Informatics is to bring together researchers and practitioners interested in the application of information and communication technologies (ICT) to healthcare and medicine in general and to the support of persons with special needs in particular.
Mantas, John; Hasman, Arie
The updated version of the IMIA educational recommendations has given an adequate guidelines platform for developing educational programs in Biomedical and Health Informatics at all levels of education, vocational training, and distance learning. This chapter will provide a brief introduction of the
Thomas, Dennis G.; Klaessig, Fred; Harper, Stacey L.; Fritts, Martin; Hoover, Mark D.; Gaheen, Sharon; Stokes, Todd H.; Reznik-Zellen, Rebecca; Freund, Elaine T.; Klemm, Juli D.; Paik, David S.; Baker, Nathan A.
There are several issues to be addressed concerning the management and effective use of information (or data), generated from nanotechnology studies in biomedical research and medicine. These data are large in volume, diverse in content, and are beset with gaps and ambiguities in the description and characterization of nanomaterials. In this work, we have reviewed three areas of nanomedicine informatics: information resources; taxonomies, controlled vocabularies, and ontologies; and information standards. Informatics methods and standards in each of these areas are critical for enabling collaboration, data sharing, unambiguous representation and interpretation of data, semantic (meaningful) search and integration of data; and for ensuring data quality, reliability, and reproducibility. In particular, we have considered four types of information standards in this review, which are standard characterization protocols, common terminology standards, minimum information standards, and standard data communication (exchange) formats. Currently, due to gaps and ambiguities in the data, it is also difficult to apply computational methods and machine learning techniques to analyze, interpret and recognize patterns in data that are high dimensional in nature, and also to relate variations in nanomaterial properties to variations in their chemical composition, synthesis, characterization protocols, etc. Progress towards resolving the issues of information management in nanomedicine using informatics methods and standards discussed in this review will be essential to the rapidly growing field of nanomedicine informatics. PMID:21721140
Wiesner, Martin; Griebel, Lena; Becker, Kurt; Pobiruchin, Monika
Consumer Health Informatics (CHI) is a relatively new and interdisciplinary field in Medical Informatics. It focuses on consumer- rather than professional-centered services. However, the definitions and understanding of a) what is a "consumer"? or b) what is health technology in the context of CHI? and c) what factors and actors influence the usage of eHealth services? vary widely. The CHI special interest group (SIG) - associated with the German Association for Medical Informatics, Biometry and Epidemiology - conducted two workshops in 2015 to improve the common understanding on these topics. The workshop outcomes, the derived CHI-specific meta model and examples how to apply this model are presented in this paper. The model supports the definition of multi-actor contexts, as it not solely reflects the conventional patient-physician relationship but also allows for the description of second health market providers.
Jeon, Eunjoo; Kim, Jeongeun; Lee, Ji-Hyun; Kim, Jungha; Jin, Meiling; Ahn, Shinae; Jun, Jooyeon; Song, Healim; On, Jeongah; Jung, Hyesil; Hong, Yeong Joo; Yim, Suran
Objectives This study presents the current status of nursing informatics education, the content covered in nursing informatics courses, the faculty efficacy, and the barriers to and additional supports for teaching nursing informatics in Korea. Methods A set of questionnaires consisting of an 18-item questionnaire for nursing informatics education, a 6-item questionnaire for faculty efficacy, and 2 open-ended questions for barriers and additional supports were sent to 204 nursing schools via email and the postal service. Nursing schools offering nursing informatics were further asked to send their syllabuses. The subjects taught were analyzed using nursing informatics competency categories and other responses were tailed using descriptive statistics. Results A total of 72 schools (35.3%) responded to the survey, of which 38 reported that they offered nursing informatics courses in their undergraduate nursing programs. Nursing informatics courses at 11 schools were taught by a professor with a degree majoring in nursing informatics. Computer technology was the most frequently taught subject (27 schools), followed by information systems used for practice (25 schools). The faculty efficacy was 3.76 ± 0.86 (out of 5). The most frequently reported barrier to teaching nursing informatics (n = 9) was lack of awareness of the importance of nursing informatics. Training and educational opportunities was the most requested additional support. Conclusions Nursing informatics education has increased during the last decade in Korea. However, the proportions of faculty with degrees in nursing informatics and number of schools offering nursing informatics courses have not increased much. Thus, a greater focus is needed on training faculty and developing the courses. PMID:27200224
Jeon, Eunjoo; Kim, Jeongeun; Park, Hyeoun-Ae; Lee, Ji-Hyun; Kim, Jungha; Jin, Meiling; Ahn, Shinae; Jun, Jooyeon; Song, Healim; On, Jeongah; Jung, Hyesil; Hong, Yeong Joo; Yim, Suran
This study presents the current status of nursing informatics education, the content covered in nursing informatics courses, the faculty efficacy, and the barriers to and additional supports for teaching nursing informatics in Korea. A set of questionnaires consisting of an 18-item questionnaire for nursing informatics education, a 6-item questionnaire for faculty efficacy, and 2 open-ended questions for barriers and additional supports were sent to 204 nursing schools via email and the postal service. Nursing schools offering nursing informatics were further asked to send their syllabuses. The subjects taught were analyzed using nursing informatics competency categories and other responses were tailed using descriptive statistics. A total of 72 schools (35.3%) responded to the survey, of which 38 reported that they offered nursing informatics courses in their undergraduate nursing programs. Nursing informatics courses at 11 schools were taught by a professor with a degree majoring in nursing informatics. Computer technology was the most frequently taught subject (27 schools), followed by information systems used for practice (25 schools). The faculty efficacy was 3.76 ± 0.86 (out of 5). The most frequently reported barrier to teaching nursing informatics (n = 9) was lack of awareness of the importance of nursing informatics. Training and educational opportunities was the most requested additional support. Nursing informatics education has increased during the last decade in Korea. However, the proportions of faculty with degrees in nursing informatics and number of schools offering nursing informatics courses have not increased much. Thus, a greater focus is needed on training faculty and developing the courses.
Hesser, A; Cregler, L L; Lewis, L
To identify cognitive and noncognitive variables as predictors of the admission into medical school of African American college students who have participated in summer academic enrichment programs (SAEPs). The study sample comprised 309 African American college students who participated in SAEPs at the Medical College of Georgia School of Medicine from 1980 to 1989 and whose educational and occupational statuses were determined by follow-up tracking. A three-step logistic regression was used to analyze the data (with alpha = .05); the criterion variable was admission to medical school. The 17 predictor variables studied were one of two types, cognitive and noncognitive. The cognitive variables were (1) Scholastic Aptitude Test mathematics (SAT-M) score, (2) SAT verbal score, (3) college grade-point average (GPA), (4) college science GPA, (5) SAEP GPA, and (6) SAEP basic science GPA (BSGPA). The noncognitive variables were (1) gender, (2) highest college level at the time of the last SAEP application, (3) type of college attended (historically African American or predominately white), (4) number of SAEPs attended, (5) career aspiration (physician or another health science option) (6) parents who were professionals, (7) parents who were health care role models, (8) evidence of leadership, (9) evidence of community service, (10) evidence of special motivation, and (11) strength of letter of recommendation in the SAEP application. For each student the rating scores for the last four noncognitive variables were determined by averaging the ratings of two judges who reviewed relevant information in each student's file. In step 1, which explained 20% of the admission decision variance, SAT-M score, SAEP BSGPA, and college GPA were the three significant cognitive predictors identified. In step 2, which explained 31% of the variance, the three cognitive predictors identified in step 1 were joined by three noncognitive predictors: career aspiration, type of college, and
Tucker-Seeley, Reginald D.; Mitchell, Jamie A.; Shires, Deirdre A.; Modlin, Charles S., Jr.
Background: Health self-efficacy (the confidence to take care of one's health) is a key component in ensuring that individuals are active partners in their health and health care. The purpose of this study was to determine the association between financial hardship and health self-efficacy among African American men and to determine if unmet…
Garvey, W Timothy; Mechanick, Jeffrey I; Brett, Elise M; Garber, Alan J; Hurley, Daniel L; Jastreboff, Ania M; Nadolsky, Karl; Pessah-Pollack, Rachel; Plodkowski, Raymond
Development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and the American College of Endocrinology (ACE) Board of Trustees and adheres to published AACE protocols for the standardized production of clinical practice guidelines (CPGs). Recommendations are based on diligent review of clinical evidence with transparent incorporation of subjective factors. There are 9 broad clinical questions with 123 recommendation numbers that include 160 specific statements (85 [53.1%] strong [Grade A]; 48 [30.0%] intermediate [Grade B], and 11 [6.9%] weak [Grade C], with 16 [10.0%] based on expert opinion [Grade D]) that build a comprehensive medical care plan for obesity. There were 133 (83.1%) statements based on strong (best evidence level [BEL] 1 = 79 [49.4%]) or intermediate (BEL 2 = 54 [33.7%]) levels of scientific substantiation. There were 34 (23.6%) evidence-based recommendation grades (Grades A-C = 144) that were adjusted based on subjective factors. Among the 1,790 reference citations used in this CPG, 524 (29.3%) were based on strong (evidence level [EL] 1), 605 (33.8%) were based on intermediate (EL 2), and 308 (17.2%) were based on weak (EL 3) scientific studies, with 353 (19.7%) based on reviews and opinions (EL 4). The final recommendations recognize that obesity is a complex, adiposity-based chronic disease, where management targets both weight-related complications and adiposity to improve overall health and quality of life. The detailed evidence-based recommendations allow for nuanced clinical decision-making that addresses real-world medical care of patients with obesity, including screening, diagnosis, evaluation, selection of therapy, treatment goals, and individualization of care. The goal is to facilitate high-quality care of patients with obesity and provide a rational, scientific approach to management that optimizes health outcomes and safety. A1C = hemoglobin A1c AACE = American
Full Text Available Following the approval of OxyContin (Purdue Pharma, Canada for medical use, the media began to report the use of OxyContin as a street drug, representing the phenomenon as a social problem. Meanwhile, the pain medicine community has criticized the inaccurate and one-sided media coverage of the OxyContin problem. The authors of this study aimed to contribute to an understanding of both sides of this controversy by analyzing the coverage of OxyContin in newspapers and medical journals. The analyses revealed inconsistent messages about the drug from physicians in the news media and in medical journals, which has likely contributed to the drug’s perception as a social problem. The authors suggest ways to address the lack of medical consensus surrounding OxyContin. The results of this study may help resolve the concerns and conflicts surrounding this drug and other opioids.
Vaccaro, Joan A; Huffman, Fatma G
This study examined gender differences in medical advice related to diet and physical activity for obese African American adults (N = 470) with and without diabetes. Data from the 2007-2008 National Health and Nutrition Examination Survey were analyzed using logistic regression analyses. Even after sociodemographic adjustments, men were less likely to report receiving medical advice as compared with women. Both men and women given dietary and physical activity advice were more likely to follow it. Men were less likely to report currently reducing fat or calories, yet men with diabetes were 5 times more likely to state that they were reducing fat and calories as compared with women with diabetes. Gender- and disease state-specific interventions are needed comparing standard care with enhanced patient education. Moreover, these findings necessitate studies that characterize the role of the health care professional in the diagnosis and treatment of obesity and underscore patient-provider relationships.
Tatiana M. Davidson
Full Text Available African Americans and Hispanics have disproportionate rates of uncontrolled essential hypertension (EH compared to Non-Hispanic Whites. Medication non-adherence (MNA is the leading modifiable behavior to improved blood pressure (BP control. The Smartphone Medication Adherence Stops Hypertension (SMASH program was developed using a patient-centered, theory-guided, iterative design process. Electronic medication trays provided reminder signals, and Short Message Service [SMS] messaging reminded subjects to monitor BP with Bluetooth-enabled monitors. Motivational and reinforcement text messages were sent to participants based upon levels of adherence. Thirty-eight African-American (18 and Hispanic (20 uncontrolled hypertensives completed clinic-based anthropometric and resting BP evaluations prior to randomization, and again at months 1, 3 and 6. Generalized linear mixed modeling (GLMM revealed statistically significant time-by-treatment interactions (p < 0.0001 indicating significant reductions in resting systolic blood pressure (SBP and diastolic blood pressure (DBP for the SMASH group vs. the standard care (SC control group across all time points. 70.6% of SMASH subjects vs. 15.8% of the SC group reached BP control (< 140/90 mmH at month 1 (p < 0.001. At month 6, 94.4% of the SMASH vs. 41.2% of the SC group exhibited controlled BP (p < 0.003. Our findings provide encouraging evidence that efficacious mHealth, chronic disease, medical regimen, self-management programs can be developed following principles of patient-centered, theory-guided design.
Larenas-Linnemann, Désirée E S; Hauswirth, David W; Calabria, Christopher W; Sher, Lawrence D; Rank, Matthew A
Little data in the literature exist concerning patients with certain underlying medical conditions who receive allergen subcutaneous immunotherapy (SCIT). To survey allergists' experience with SCIT in patients with medical conditions considered to impose an elevated risk for untoward outcomes. A Web-based survey was conducted among members of the American Academy of Allergy, Asthma & Immunology to query about their experience with SCIT in patients with certain medical conditions. There were 1085 replies (21% response), of whom, 86% were U.S. based, 51% were suburban, 31% were academic, 42% were medium-sized practices, and 54% had >15 years' experience. In responders' opinion, SCIT was "contraindicated" in patients with the following: acquired immune deficiency syndrome (AIDS) (48%), cancer (and still receiving active treatment) (33%), severe asthma (32%), and a history of transplantation (30%). Even so, survey responders collectively gave SCIT to >2400 patients for each of these conditions: severe asthma, coronary artery disease, cancer in remission, and autoimmune disorders; and to ≥5400 patients with hypertension and ≥4100 women who became pregnant. The experience of colleagues with these patients rarely resulted in major problems (i.e., activation of underlying disease, systemic reactions to SCIT, or SCIT discontinuation), with the exception of severe asthma (12.5%), initiation of SCIT during pregnancy (5.4%), and AIDS (4.2%). For most other conditions, it was ≤1.5% (e.g., continue during pregnancy, cancer in remission, history of transplantation, positive human immunodeficiency virus and no AIDS). According to the experience of a large group of practicing allergists, the American Academy of Allergy, Asthma & Immunology members, few medical conditions seemed to pose an elevated risk for untoward outcomes from SCIT. Because these are survey results, prospective research might yield even more solid data.
Maragh-Bass, Allysha C; Denison, Julie A; Thorpe, Roland J; Knowlton, Amy R
Research suggests a syndemic of substance use, mental illness, and familial conflict is associated with poor HIV medical outcomes among African American persons living with HIV (PLHIV). Social support may facilitate positive health outcomes. This study explores psychosocial correlates of HIV medical outcomes, defined as undetectable viral load (UVL) and acute care minimization. Data were from baseline of the BEACON study (N = 351). UVL was ≤40 copies/mL. Acute care minimization was defined as no ER visits and/or hospitalizations in 6 months. Descriptive statistics and Poisson regression were implemented (N = 351). Moderate syndemic burden was associated with viral suppression. Individuals with main partner caregivers had 35% higher likelihood of viral suppression than individuals whose main supporters were neither kin nor main partners (adjusted point-prevalence rate ratio [APR] = 1.35; 95% CI [1.05, 1.74]). Surprisingly, individuals with more health-related support were more likely to use acute care than individuals with less health-related support (pInteraction analyses showed that physical function modified the relationship between main supporter type and acute care minimization. Results suggest that social support receipt was not consistently associated with HIV medical outcomes. Conversely, higher syndemic burden may have facilitated positive outcomes through necessitating increased rates of health care engagement. Health care professionals should elicit discussion of social support to strengthen PLHIVs' and their supporters' relationships to improve their health. Results highlight the need for culturally tailored interventions to improve HIV medical outcomes among African American PLHIV substance users.
Sobin, Lindsay B.; Koester, Lindsey A.; Harris, Tucker M.
Objectives To describe levels of burnout and impostor syndrome (IS) in medical students, and to recognize demographic differences in those experiencing burnout and IS. Methods Research participants included 2,612 medical students who entered Jefferson Medical College between 2002 and 2012. This sample was divided into two groups: Matriculants between 2002 and 2007 (n=1,380) and between 2008 and 2012 (n=1,232). Data for 2002-2007 matriculants were subjected to EFA (principal component factor extraction), and data for matriculants of 2008-2012 were used for CFA (structural equation modeling, and root mean square error for approximation). Results One hundred and thirty-eight students completed the questionnaire. Female gender was significantly associated with IS (χ2(3)=10.6, p=0.004) with more than double the percentage of females displaying IS than their male counterparts (49.4% of females versus 23.7% of males). IS was significantly associated with the burnout components of exhaustion (χ2 (2)=5.9, p=0.045), cynicism (χ2(2)=9.4, p=0.004), emotional exhaustion (χ2(2)=8.0, p=0.018), and depersonalization (χ2 (2)=10.3, p=0.006). The fourth year of medical school was significantly associated with IS (χ2(3)=10.5, p=0.015). Conclusions Almost a quarter of male medical students and nearly half of female students experience IS and IS was found to be significantly associated with burnout indices. Given the high psychological morbidity of these conditions, this association cannot be ignored. It behooves us to reconsider facets of medical education (i.e. shame-based learning and overall teaching style) and optimize the medical learning environment. PMID:27802178
Joy, Javed A.; Julius, Rose J.; Akter, Rashida; Baron, David A.
Purpose: Every year increasing numbers of candidates request special accommodations for high-stakes medical licensing examinations, due to ADHD, on the basis of the Americans with Disabilities Act (ADA). This poses significant challenges for both the applicant and the medical boards and has significant financial, legal, and ethical implications.…
Simpao, Allan F; Ahumada, Luis M; Gálvez, Jorge A; Rehman, Mohamed A
Federal investment in health information technology has incentivized the adoption of electronic health record systems by physicians and health care organizations; the result has been a massive rise in the collection of patient data in electronic form (i.e. "Big Data"). Health care systems have leveraged Big Data for quality and performance improvements using analytics-the systematic use of data combined with quantitative as well as qualitative analysis to make decisions. Analytics have been utilized in various aspects of health care including predictive risk assessment, clinical decision support, home health monitoring, finance, and resource allocation. Visual analytics is one example of an analytics technique with an array of health care and research applications that are well described in the literature. The proliferation of Big Data and analytics in health care has spawned a growing demand for clinical informatics professionals who can bridge the gap between the medical and information sciences.
This book is a timely report on current neurotechnology research. It presents a snapshot of the state of the art in the field, discusses current challenges and identifies new directions. The book includes a selection of extended and revised contributions presented at the 2nd International Congress on Neurotechnology, Electronics and Informatics (NEUROTECHNIX 2014), held October 25-26 in Rome, Italy. The chapters are varied: some report on novel theoretical methods for studying neuronal connectivity or neural system behaviour; others report on advanced technologies developed for similar purposes; while further contributions concern new engineering methods and technological tools supporting medical diagnosis and neurorehabilitation. All in all, this book provides graduate students, researchers and practitioners dealing with different aspects of neurotechnologies with a unified view of the field, thus fostering new ideas and research collaborations among groups from different disciplines.
Pena, J. J.; Rossell, M. A.; Calvo, J. L.; Vega, J. M.
The Ibero-American Group of Scientific Societies of Radiological Protection (GRIAPRA) was constituted on 30-September-1996 as the end of a process that the SEPR began in its V National Congress (Santiago de Compostela, 1994). In this work are presented some of the results of the experience accumulated by the SEPR (GRIAPRA) in training and professional update of latin-american radiologists,medical physicists and technician during these last six years:Cuba (La Habana 1998), Peru (Lima 1999), Mexico (Guadalajara 2000), Brazil (Recife, 2001), Peru (Lima 2002) and Cuba (La Habana 2003). They are shown the professional profiles of the american colleagues that in number superior to 300 persons have been accepted in these training courses imparted by members very qualified of the SEPR and SEFM, the theoric-practical structure of these courses, the design of their programming, documentation, the sources of financing, the general analysis of the wisdoms and mistakes and the proposal to continue with this cooperation in the future. (Author)
Zurada, Anna; Gielecki, Jerzy St; Osman, Nilab; Tubbs, R Shane; Loukas, Marios; Zurada-Zielińska, Agnieszka; Bedi, Neru; Nowak, Dariusz
Past research in medical education has addressed the study of gross anatomy, including the most effective learning techniques, comparing the use of cadavers, dissection, anatomy atlases, and multimedia tools. The aim of this study was to demonstrate similarities and differences among American, Asian, and European medical students (MS) regarding different study methods and to see how these methods affected their clinical skills. To analyze the varying study methods of European, American, and Asian MS in our program and in order to elucidate any ethnic and cultural differences a survey was conducted. A total of 705 international MS, from the Polish (PD), American (AD), and Taiwanese (TD) divisions, were asked to voluntarily participate in the questionnaire. Students were asked the following questions: which methods they used to study anatomy, and which of the methods they believed were most efficient for comprehension, memorization, and review. The questions were based on a 5-point Likert scale, where 5 was 'strongly agree', and 1 was 'strongly disagree'. The PD and AD preferred the use of dissections and prosected specimens to study anatomy. The TD showed less interest in studying from prosected specimens, but did acknowledge that this method was more effective than using atlases, plastic models, or CD-ROMs. Multimedia tools were mainly used for radiological anatomy and review and also for correctly typing proper names of structures using exact anatomical terminology. The findings highlight the differences in study techniques among students from different ethnic backgrounds. The study approaches used in order to accomplish learning objectives was affected by cultural norms that influenced each student group. These differences may be rooted in technological, religious, and language barriers, which can shape the way MS approach learning.
Villwock, Jennifer A; Sobin, Lindsay B; Koester, Lindsey A; Harris, Tucker M
To describe levels of burnout and impostor syndrome (IS) in medical students, and to recognize demographic differences in those experiencing burnout and IS. Anonymous survey administered online in 2014 that included demographic data, the Maslach Burnout Inventory and an IS screening questionnaire. Main outcome measures were level of burnout, and presence or absence of imposter syndrome. The presence of IS and burnout components were analyzed across age, gender, race, year of training, intention to pursue fellowship training, and greater than one year of work experience outside of medicine using chi-squared tests. The association between burnout and IS was also compared using chi-squared tests. One hundred and thirty-eight students completed the questionnaire. Female gender was significantly associated with IS (χ 2 (3) =10.6, p=0.004) with more than double the percentage of females displaying IS than their male counterparts (49.4% of females versus 23.7% of males). IS was significantly associated with the burnout components of exhaustion (χ 2 (2) =5.9, p=0.045), cynicism (χ 2 (2) =9.4, p=0.004), emotional exhaustion (χ 2 (2) =8.0, p=0.018), and depersonalization (χ 2 (2) =10.3, p=0.006). The fourth year of medical school was significantly associated with IS (χ 2 (3) =10.5, p=0.015). Almost a quarter of male medical students and nearly half of female students experience IS and IS was found to be significantly associated with burnout indices. Given the high psychological morbidity of these conditions, this association cannot be ignored. It behooves us to reconsider facets of medical education (i.e. shame-based learning and overall teaching style) and optimize the medical learning environment.
Cybernetics and informatics being a high-profile and fast-moving fields, the papers included in this proceedings will command a wide professional and academic readership. This book covers the very latest developments in the field of cybernetics and informatics. The 2012 conference in Chongqing, China, combined a focus on innovative technologies with an emphasis on sustainable solutions and strategies. Attended by leading figures from academia and industry whose work is represented here, the conference allowed effective cross-pollination between the theoretical and applied sectors of the field. Conference organizers received more than 1,000 papers, of which only ten percent were chosen to be featured in this publication. All of the papers are at the leading edge of developments, and so this book will not only ensure that the very best current work is disseminated, but that it also acts as a spur to future research.
McDonald, Furman S; Duhigg, Lauren M; Arnold, Gerald K; Hafer, Ruth M; Lipner, Rebecca S
Some have questioned whether successful performance in the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) program is meaningful. The association of the ABIM Internal Medicine (IM) MOC examination with state medical board disciplinary actions is unknown. To assess risk of disciplinary actions among general internists who did and did not pass the MOC examination within 10 years of initial certification. Historical population cohort study. The population of internists certified in internal medicine, but not a subspecialty, from 1990 through 2003 (n = 47,971). ABIM IM MOC examination. General internal medicine in the USA. The primary outcome measure was time to disciplinary action assessed in association with whether the physician passed the ABIM IM MOC examination within 10 years of initial certification, adjusted for training, certification, demographic, and regulatory variables including state medical board Continuing Medical Education (CME) requirements. The risk for discipline among physicians who did not pass the IM MOC examination within the 10 year requirement window was more than double than that of those who did pass the examination (adjusted HR 2.09; 95% CI, 1.83 to 2.39). Disciplinary actions did not vary by state CME requirements (adjusted HR 1.02; 95% CI, 0.94 to 1.16), but declined with increasing MOC examination scores (Kendall's tau-b coefficient = - 0.98 for trend, p actions were less severe among those passing the IM MOC examination within the 10-year requirement window than among those who did not pass the examination. Passing a periodic assessment of medical knowledge is associated with decreased state medical board disciplinary actions, an important quality outcome of relevance to patients and the profession.
The construction and management of exhibition informatization is the main task and choke point during the process of Chinese exhibition industry’s transformation and promotion. There are three key points expected to realize a breakthrough during the construction of Chinese exhibition informatization, and the three aspects respectively are adopting service outsourcing to construct and maintain the database, adopting advanced chest card technology to collect various kinds of information, developing statistics analysis to maintain good cutomer relations. The success of Chinese exhibition informatization mainly calls for mature suppliers who can provide construction and maintenance of database, the proven technology, a sense of data security, advanced chest card technology, the ability of data mining and analysis and the ability to improve the exhibition service basing on the commercial information got from the data analysis. Several data security measures are expected to apply during the process of system developing, including the measures of the terminal data security, the internet data security, the media data security, the storage data security and the application data security. The informatization of this process is based on the chest card designing. At present, there are several types of chest card technology: bar code chest card; two-dimension code card; magnetic stripe chest card; smart-chip chest card. The information got from the exhibition data will help the organizers to make relevant service strategies, quantify the accumulated indexes of the customers, and improve the level of the customer’s satisfaction and loyalty, what’s more, the information can also provide more additional services like the commercial trips, VIP ceremonial reception.
This book deals with present situation and view of research and development project by industry, which includes general machinery industry, the steel industry, non ferrous metal industry, petrochemistry industry, auto industry, shipbuilding industry, aerospace engineering industry, daily supplies industry, fine chemistry industry, the ceramic industry, plate glass industry, biology life industry, electron industry, information industry, and semiconductor industry. It also describes project management of R and D and informatization of industry.367
Roč. 20, č. 6 (2009), s. 743-750 ISSN 1180-4009. [TIES 2007. Annual Meeting of the International Environmental Society /18./. Mikulov, 16.08.2007-20.08.2007] Institutional research plan: CEZ:AV0Z10300504 Keywords : biomedical informatics * biomedical statistics * genetic information * forensic dentistry Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 1.000, year: 2009
What kind of knowledges, skills and competences may be required by Techno-Anthropology engaging with health informatics? If we understand Techno-Anthropology to mean conducting anthropological analyses of the interwoven and mutually shaping relationship between organizing, technologies and actors...... professions and organizations; and skilled in generating analyses and proposing new solutions. Also, people with insight into how action, technologies and organizing are interwoven and redistribute competences, responsibilities and risks are invaluable: Look at from afar, technologies seem to cause...
Campbell, Jayne M; Roderer, Nancy K
Preparing librarians to meet the information challenges faced in the current and future health care environments is critical. At Johns Hopkins University, three NLM-funded fellowship programs provide opportunities for librarians to utilize the rich environments of the Welch Medical Library and the Division of Health Sciences Informatics in support of life-long learning.
Hambly, Kevin; Danzer, Joseph; Muskal, Steven; Debe, Derek A
Structural genomics projects are producing protein structure data at an unprecedented rate. In this paper, we present the Target Informatics Platform (TIP), a novel structural informatics approach for amplifying the rapidly expanding body of experimental protein structure information to enhance the discovery and optimization of small molecule protein modulators on a genomic scale. In TIP, existing experimental structure information is augmented using a homology modeling approach, and binding sites across multiple target families are compared using a clique detection algorithm. We report here a detailed analysis of the structural coverage for the set of druggable human targets, highlighting drug target families where the level of structural knowledge is currently quite high, as well as those areas where structural knowledge is sparse. Furthermore, we demonstrate the utility of TIP's intra- and inter-family binding site similarity analysis using a series of retrospective case studies. Our analysis underscores the utility of a structural informatics infrastructure for extracting drug discovery-relevant information from structural data, aiding researchers in the identification of lead discovery and optimization opportunities as well as potential "off-target" liabilities.
Yosipof, Abraham; Shimanovich, Klimentiy; Senderowitz, Hanoch
Material informatics is engaged with the application of informatic principles to materials science in order to assist in the discovery and development of new materials. Central to the field is the application of data mining techniques and in particular machine learning approaches, often referred to as Quantitative Structure Activity Relationship (QSAR) modeling, to derive predictive models for a variety of materials-related "activities". Such models can accelerate the development of new materials with favorable properties and provide insight into the factors governing these properties. Here we provide a comparison between medicinal chemistry/drug design and materials-related QSAR modeling and highlight the importance of developing new, materials-specific descriptors. We survey some of the most recent QSAR models developed in materials science with focus on energetic materials and on solar cells. Finally we present new examples of material-informatic analyses of solar cells libraries produced from metal oxides using combinatorial material synthesis. Different analyses lead to interesting physical insights as well as to the design of new cells with potentially improved photovoltaic parameters. © 2016 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.
Garcia, Edna; Fisher, Patrick B
To inform the pathology and laboratory field of the most recent national wage data from the American Society for Clinical Pathology (ASCP). Historically, the results of this biennial survey have served as a basis for additional research on laboratory recruitment, retention, education, marketing, certification, and advocacy. The 2015 wage survey was conducted through collaboration between the ASCP's Institute of Science, Technology, and Policy in Washington, DC, and the ASCP Board of Certification in Chicago, Illinois. Electronic survey invitations were sent to individuals who are currently practicing in the field. Data reveal increased salaries since 2013 for all staff-level laboratory professionals surveyed except phlebotomists and pathologists' assistants. Laboratory assistants and phlebotomists, regardless of level, continue to have lower salaries while pathologists' assistants and administration personnel have higher salaries than the rest of the laboratory professions surveyed. Survey results put emphasis on strategic recruitment and retention by laboratory training programs and institutions that hire laboratory professionals. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: email@example.com
Mayta-Tristán, Percy; Pereyra-Elías, Reneé; Montenegro-Idrogo, Juan José; Mejia, Christian R; Inga-Berrospi, Fiorella; Mezones-Holguín, Edward
Latin America is undergoing a human resource crisis in health care in terms of labor shortage, misdistribution and poor orientation to primary care. Workforce data are needed to inform the planning of long-term strategies to address this problem. This study aimed to evaluate the academic and motivational profile, as well as the professional expectations, of Latin American medical students. We conducted an observational, cross-sectional, multi-country study evaluating medical students from 11 Spanish-speaking countries in 2011-2012. Motivations to study medicine, migration intentions, intent to enter postgraduate programs, and perceptions regarding primary care were evaluated via a self-administered questionnaire. Outcomes were measured with pilot-tested questions and previously validated scales. A total of 11,072 valid surveys from 63 medical schools were gathered and analyzed. This study describes the profile and expectations of the future workforce being trained in Latin America. The obtained information will be useful for governments and universities in planning strategies to improve their current state of affairs regarding human resources for health care professions.
Oh, Kyeung Mi; Jun, Jungmi; Zhou, Qiuping; Kreps, Gary
Cancer is the leading cause of death for Korean-Americans (KAs), while cancer screening rates among KAs have been consistently low. Seven semi-structured focus group interviews with 34 KA women aged 40 or older in the Washington, DC metropolitan area were conducted to explore the perceptions of KA women about seeking physical examinations and cancer screening services in Korea. Data were analyzed using a framework approach. Informants positively perceived the use of health screening services in Korea in comparison to seeking such services in the US. Decision-making factors included cost benefits, high quality services, and more convenient screening procedures in Korea. These benefits outweighed the risks of delaying health care and travelling a vast distance with incurring additional travel costs. Motivations to seek these services in Korea included opportunities to visit their homeland and to enjoy comfortable communication with their native language. The increase of available information about Korean medical services due to the industry's aggressive marketing/PR was identified as a facilitator. Most informants did not recognize possible negative health outcomes of obtaining services in Korea such as inappropriate follow up care if having abnormal findings. Educational programs are needed to educate KAs about the benefits and risks of getting the services in Korea and proper follow up care in the US. Health care providers need to know the different cancer risks and screening needs for this population.
Ellis, Beverley; Roberts, Jean; Cooper, Helen
This case study report of the establishment of a national repository of multi-media materials describes the creation process, the challenges faced in putting it into operation and the opportunities for the future. The initial resource has been incorporated under standard library and knowledge management practices. A collaborative action research method was used with active experts in the domain to determine the requirements and priorities for further development. The National Health Informatics Collection (NatHIC) is now accessible and the further issues are being addressed by inclusion in future University and NHS strategic plans. Ultimately the Collection will link with other facilities that contribute to the description and maintenance of effective informatics in support of health globally. The issues raised about the National Health Informatics Collection as established in the UK have resonance with the challenges of capturing the overall historic development of an emerging discipline in any country.
Goodin, Burel R; Pham, Quyen T; Glover, Toni L; Sotolongo, Adriana; King, Christopher D; Sibille, Kimberly T; Herbert, Matthew S; Cruz-Almeida, Yenisel; Sanden, Shelley H; Staud, Roland; Redden, David T; Bradley, Laurence A; Fillingim, Roger B
Studies have shown that perceived racial discrimination is a significant predictor of clinical pain severity among African Americans. It remains unknown whether perceived racial discrimination also alters the nociceptive processing of painful stimuli, which, in turn, could influence clinical pain severity. This study examined associations between perceived racial discrimination and responses to noxious thermal stimuli among African Americans and non-Hispanic Whites. Mistrust of medical researchers was also assessed given its potential to affect responses to the noxious stimuli. One-hundred and 30 (52% African American, 48% non-Hispanic White) community-dwelling older adults with symptomatic knee osteoarthritis completed two study sessions. In session one, individuals provided demographic, socioeconomic, physical and mental health information. They completed questionnaires related to perceived lifetime frequency of racial discrimination and mistrust of medical researchers. In session two, individuals underwent a series of controlled thermal stimulation procedures to assess heat pain sensitivity, particularly heat pain tolerance. African Americans were more sensitive to heat pain and reported greater perceived racial discrimination as well as greater mistrust of medical researchers compared with non-Hispanic Whites. Greater perceived racial discrimination significantly predicted lower heat pain tolerance for African Americans but not non-Hispanic Whites. Mistrust of medical researchers did not significantly predict heat pain tolerance for either racial group. These results lend support to the idea that perceived racial discrimination may influence the clinical pain severity of African Americans via the nociceptive processing of painful stimuli.
Ana Sekulovska; Pece Mitrevski
Seeing the informatization as a measure of the educational policy, we propose an informatization level assessment framework and introduce a composite indicator – Education Informatization Index, calculated as a weighted sum by applying the Rank-Order Centroid method for weight designation. Although it is made up of only two main categories (Educational Policy Implementation subindex and Educational Policy Creation subindex) and a total of six individual indicators, it captures well all the so...
Liang, Guanhui; Lv, Guizhou; Meng, Yafeng
With the development of informatization, the traditional teaching method of certain radar transmitter is more and more difficult to meet the need of cultivating new type of high-quality military talents. This paper first analyzes the problems traditional teaching method of certain radar transmitter, and then puts forward the strategy of informatization teaching, and finally elaborates the concrete steps and contents of informatization teaching. Using the multimedia maintenance training system, information simulation training system and network courses and other informatization means, effectively improves the master degree to radar transmitter by trainees, but also lays a good foundation for repair in the next step.
In this presentation author deals with next problems of Slovenske elektrarne, Plc (SE): - Centralisation and optimisation of informatics management; - New technologies within Integrated Informatics System IIS-SE: presentation of preliminary Project of 2 nd generation IIS-SE; - Centralisation of the selected data processing. At the present the intensive process of restructuring is taking place in SE, Plc, focused on increasing of the effectiveness of the pursued activities. In connection with this the Informatics section solves two projects: More effective self-management and human resources; Change of Informatics system architecture from decentralised to the centralised ones with an aim to consolidate all information and to make new conditions for higher mobility
Objectives To deliver an estimate of bullying among residents and fellows in the United States graduate medical education system and to explore its prevalence within unique subgroups. Design/Setting/Participants A national cross-sectional survey from a sample of residents and fellows who completed an online bullying survey conducted in June 2015. The survey was distributed using a chain sampling method that relied on electronic referrals from 4,055 training programs, with 1,791 residents and fellows completing the survey in its entirety. Survey respondents completed basic demographic and programmatic information plus four general bullying and 20 specific bullying behavior questions. Between-group differences were compared for demographic and programmatic stratifications. Main Outcomes/Measures Self-reported subjected to workplace bullying from peers, attendings, nurses, ancillary staff, or patients in the past 12 months. Results Almost half of the respondents (48%) reported being subjected to bullying although both those subjected and not subjected reported experiencing ≥ 1 bullying behaviors (95% and 39% respectively). Attendings (29%) and nurses (27%) were the most frequently identified source of bullying, followed by patients, peers, consultants and staff. Attempts to belittle and undermine work and unjustified criticism and monitoring of work were the most frequently reported bullying behaviors (44% each), followed by destructive innuendo and sarcasm (37%) and attempts to humiliate (32%). Specific bullying behaviors were more frequently reported by female, non-white, shorter than bullying in the United States graduate medical education programs. Including specific questions on bullying in the Accreditation Council for Graduate Medical Education annual resident/fellow survey, implementation of anti-bullying policies, and a multidisciplinary approach engaging all stakeholders may be of great value to eliminate these pervasive behaviors in the field of
Amar R Chadaga
Full Text Available To deliver an estimate of bullying among residents and fellows in the United States graduate medical education system and to explore its prevalence within unique subgroups.A national cross-sectional survey from a sample of residents and fellows who completed an online bullying survey conducted in June 2015. The survey was distributed using a chain sampling method that relied on electronic referrals from 4,055 training programs, with 1,791 residents and fellows completing the survey in its entirety. Survey respondents completed basic demographic and programmatic information plus four general bullying and 20 specific bullying behavior questions. Between-group differences were compared for demographic and programmatic stratifications.Self-reported subjected to workplace bullying from peers, attendings, nurses, ancillary staff, or patients in the past 12 months.Almost half of the respondents (48% reported being subjected to bullying although both those subjected and not subjected reported experiencing ≥ 1 bullying behaviors (95% and 39% respectively. Attendings (29% and nurses (27% were the most frequently identified source of bullying, followed by patients, peers, consultants and staff. Attempts to belittle and undermine work and unjustified criticism and monitoring of work were the most frequently reported bullying behaviors (44% each, followed by destructive innuendo and sarcasm (37% and attempts to humiliate (32%. Specific bullying behaviors were more frequently reported by female, non-white, shorter than < 5'8 and BMI ≥ 25 individuals.Many trainees report experiencing bullying in the United States graduate medical education programs. Including specific questions on bullying in the Accreditation Council for Graduate Medical Education annual resident/fellow survey, implementation of anti-bullying policies, and a multidisciplinary approach engaging all stakeholders may be of great value to eliminate these pervasive behaviors in the field of
The subjects covered are the following: Low energy X rays qualities, medical physicist, simulation of irradiation X, dosimetry, radiotherapy, calibration, digital mammography, management of radioactive specimens, radio-surgery, genetic algorithm for the ventricular volume mensuration, SPECT systems, electronic paramagnetic resonance, radio-diagnose service, bra qui-therapy, radio sensibility, mammographic systems, thermoluminescent dosimetry, magnetic resonance, radiological protection, radiological safety, Venezuelan legislation, tomographic images, linear energy transfer (LET), regional master in physics medicine, heart function in nuclear medicine, renography, protons beam, nuclear medicine equipment. Individual papers have been analysed and submitted to INIS separately [es
Makhni, Eric C; Buza, John A; Byram, Ian; Ahmad, Christopher S
The increased physical demands of professional athletes predispose this patient population to a unique set of injuries typically not seen in the general population. This systematic literature review investigates the nature of injury reporting (both orthopedic and nonorthopedic conditions) in the medical literature of professional athletes in the National Football League (NFL), Major League Baseball (MLB), the National Basketball Association (NBA), and the National Hockey League (NHL). Rigorous reporting of sports injuries helps clinicians better understand disease mechanisms relevant to specific sports. The nature of injury reporting will differ within each professional sport and reflect the anatomic emphasis of each sport. An electronic literature search of all publications addressing injuries and medical conditions among professional athletes in the NFL, MLB, NBA, and NHL was conducted using the Pubmed/Medline, Scopus, and Embase databases through January 2013. Retrieved publications were categorized by journal type, medical type, and area of focus. A total of 536 publications met all inclusion criteria. There were a higher number of articles regarding the NFL (n = 211) and MLB (n = 216) when compared with the NBA (n = 34) or NHL (n = 75). The NFL had significantly more articles addressing nonorthopedic injuries/medical issues than were found with the MLB, NBA, or NHL (109 vs 75, 14, 41, respectively). Both the NFL (33 of 109, 30%) and NHL (6 of 41, 15%) had a relatively high percentage of articles regarding concussions/neurology, and MLB had a relatively high percentage of articles dedicated to vascular medicine (13 of 65, 20%). The proportion of publications dedicated to the knee/lower leg were highest in the NFL (29 of 102, 28%) and NBA (9 of 20, 45%), those dedicated to the shoulder/elbow were highest in MLB (113 of 151, 75%), and those dedicated to the hip/pelvis were highest in the NHL (16 of 34, 47%). The number and type of publications vary among the 4
Sapci, A H; Sapci, H A
This article aimed to evaluate the effectiveness of newly established innovative smart home healthcare and health informatics laboratories, and a novel laboratory course that focuses on experiential health informatics training, and determine students' self-confidence to operate wireless home health monitoring devices before and after the hands-on laboratory course. Two web-based pretraining and posttraining questionnaires were sent to 64 students who received hands-on training with wireless remote patient monitoring devices in smart home healthcare and health informatics laboratories. All 64 students completed the pretraining survey (100% response rate), and 49 students completed the posttraining survey (76% response rate). The quantitative data analysis showed that 95% of students had an interest in taking more hands-on laboratory courses. Sixty-seven percent of students had no prior experience with medical image, physiological data acquisition, storage, and transmission protocols. After the hands-on training session, 75.51% of students expressed improved confidence about training patients to measure blood pressure monitor using wireless devices. Ninety percent of students preferred to use a similar experiential approach in their future learning experience. Additionally, the qualitative data analysis demonstrated that students were expecting to have more courses with hands-on exercises and integration of technology-enabled delivery and patient monitoring concepts into the curriculum. This study demonstrated that the multidisciplinary smart home healthcare and health informatics training laboratories and the hands-on exercises improved students' technology adoption rates and their self-confidence in using wireless patient monitoring devices. Schattauer GmbH Stuttgart.
Luz Dalia Sanchez, MD, MCP, MHA, PhD
Full Text Available Objective: to describe cultural beliefs and medication-taking-behavior about pregnancy in African-American and Latina women. Design: qualitative study using phenomenological methodology; face-to-face, semi structured interviews and focus group. Thematic analysis was done to obtain themes consistent with the research objective. Setting: Maricopa County, Arizona, Department of Public-health Programs, November 2008 through April 2009.Participants: women seeking public-health services in the greater Phoenix, Arizona.Results: fifteen adult women representing two ethnic groups (seven African-Americans and eight Latinas participated. Themes derived from the interview data included: “The Dilemma: To Become or Not to Become Pregnant;” “The Ideal Stress-free World: Support System;” “Changing Worlds: Wanting Dependency;” and “The Health care System: Disconnection from Pregnancy to Postpartum.”Conclusions: based on the cultural themes: 1. pregnancies were not planned; 2. healthy life-style changes were not likely to occur during pregnancy; 3. basic facts about the biology of sexual intercourse and pregnancy were not understood, and there was no usage of any preconceptional or prenatal medications; and 4. professional health care was not desired or considered necessary (except during delivery. These cultural beliefs can contribute to negative birth outcomes, and need to be considered by pharmacists and other health-care providers. The information gained from this study can guide the implementation of educational programs developed by pharmacists that are more sensitive to the cultural beliefs and points of view of these particular women. Such programs would thus be more likely to be favorably received and utilized.
Miguel A. Serra Valdés
Full Text Available Introduction: One of the infectious illnesses that have repercussion in Latin America are the Chagas illness. Objective: with the objective of identifying the students with positive serology for the illness of Chagas and describe the characteristics in the same thing with focussing epidemiological carried out to him the present study. Method: It become fulfilled a observational investigation, descriptive and prospectival. It decided the prevalencial in the Latin American students of medicine that resides in the school Salvador Allende in the period understanded between October of the 2009 to January of the 2010 by means of serology, other clinical studieses and examination. They took shelter the variables of the clinical records and of personal interview.. Results: Affected 50 of the Bolivian delegation. The prevalence went of 6.6% of this delegation. Have clinical symptoms. The detected alterations went the ventricular hypertrophy left and the disorders of transportation and of the rhythm for electrocardiogram. It predominated the masculine sex and the rural origin. It found variability in the results of laboratory, being positive in their country and negative in Cuba and vice versa. Single 56% fulfilled the treatment. The adverse reactions went minims. Conclusion: It constitutes a sanitary problem and demands a better diagnosis, control and follow-up.
Fraser, J J
The purpose of this technical report is to provide pediatricians with an understanding of past crises within the professional liability insurance industry, the difficulties of the tort system, and alternative strategies for resolving malpractice disputes that have been applied to medical malpractice actions. Through this report, pediatricians will gain a technical understanding of common alternative dispute resolution (ADR) strategies. The report explains the distinctions between various ADR methods in terms of process and outcome, risks and benefits, appropriateness to the nature of the dispute, and long-term ramifications. By knowing these concepts, pediatricians faced with malpractice claims will be better-equipped to participate in the decision-making with legal counsel on whether to settle, litigate, or explore ADR options.
Andrea S. Varela-Stokes
Full Text Available Interest in microbial communities, or microbiota, of blood-feeding arthropods such as ticks (order Parasitiformes, suborder Ixodida is increasing. Studies on tick microorganisms historically emphasized pathogens of high medical or veterinary importance. Current techniques allow for simultaneous detection of pathogens of interest, non-pathogenic symbionts, like Coxiella-LE and Francisella-LE, and microorganisms of unknown pathogenic potential. While each generation of ticks begins with a maternally acquired repertoire of microorganisms, microhabitats off and on vertebrate hosts can alter the microbiome during the life cycle. Further, blood-feeding may allow for horizontal exchange of various pathogenic microbiota that may or may not also be capable of vertical transmission. Thus, the tick microbiome may be in constant flux. The geographical spread of tick vector populations has resulted in a broader appreciation of tick-borne diseases and tick-associated microorganisms. Over the last decade, next-generation sequencing technology targeting the 16S rRNA gene led to documented snapshots of bacterial communities among life stages of laboratory and field-collected ticks, ticks in various feeding states, and tick tissues. Characterizing tick bacterial communities at population and individual tissue levels may lead to identification of markers for pathogen maintenance, and thus, indicators of disease “potential” rather than disease state. Defining the role of microbiota within the tick may lead to novel control measures targeting tick-bacterial interactions. Here, we review our current understanding of microbial communities for some vectors in the family Ixodidae (hard ticks in North America, and interpret published findings for audiences in veterinary and medical fields with an appreciation of tick-borne disease.
McGowan, Julie J; Cusack, Caitlin M
While much attention has been paid to the short-term impact that widespread adoption of health information technology (health IT) will have on the healthcare system, there is a corresponding need to look at the long-term effects that extant policies may have on health IT system resilience, innovation, and related ethical, social/legal issues. The American Medical Informatics Association's 2010 Health Policy Conference was convened to further the national discourse on the issues surrounding these longer-term considerations. Conference participants self-selected into three broad categories: resilience in healthcare and health IT; ethical, legal, and social challenges; and innovation, adoption, and sustainability. The discussions about problem areas lead to findings focusing on the lack of encouragement for long-term IT innovation that may result from current health IT policies; the potential impact of uneven adoption of health IT based on the exclusions of the current financial incentives; the weaknesses of contingency and risk mitigation planning that threaten system resilience; and evolving standards developed in response to challenges relating to the security, integrity, and availability of electronic health information. This paper discusses these findings and also offers recommendations that address the interwoven topics of innovation, resilience, and adoption. The goal of this paper is to encourage public and private sector organizations that have a role in shaping health information policy to increase attention to developing a national strategy that assures that health IT innovation and resilience are not impeded by shorter-term efforts to implement current approaches emphasizing adoption and meaningful use of electronic health records. PMID:22037887
Himmelstein, D U; Lewontin, J P; Woolhandler, S
The purpose of this study was to elucidate the social and economic impact of health sector employment. US medical care employment was analyzed for each year between 1968 and 1993, with data from the March Current Population Survey. Between 1968 and 1993, medical care employment grew from 4.32 million to 11.40 million persons, accounting for 5.7% of all jobs in 1968 and 8.4% in 1993. Today, one seventh of employed women work in medical care; they hold 78% of medical care jobs. One fifth of all employed African-American women work in medical care. African-Americans hold 15.5% of jobs in the health sector: they hold 24.1% of the jobs in nursing homes, 15.9% of the jobs in hospitals, but only 5.6% of the jobs in practitioners' offices. Hispanics constitute 6.4% of medical care employees. Real wages rose 25% to 50% between 1968 and 1993 for most health occupations. Wages of registered nurses rose 86%; physicians' incomes rose 22%. Wages of nursing home workers were far lower than those of comparable hospital workers, and the gap has widened. In 1993, 11.7% of all medical care workers lacked health insurance and 597 000 lived in poverty. Hospital cuts and the continuing neglect of long-term care exacerbate unemployment and poverty among women and African Americans.
The article provides an overview of current trends in personal sensor, signal and imaging informatics, that are based on emerging mobile computing and communications technologies enclosed in a smartphone and enabling the provision of personal, pervasive health informatics services. The article reviews examples of these trends from the PubMed and Google scholar literature search engines, which, by no means claim to be complete, as the field is evolving and some recent advances may not be documented yet. There exist critical technological advances in the surveyed smartphone technologies, employed in provision and improvement of diagnosis, acute and chronic treatment and rehabilitation health services, as well as in education and training of healthcare practitioners. However, the most emerging trend relates to a routine application of these technologies in a prevention/wellness sector, helping its users in self-care to stay healthy. Smartphone-based personal health informatics services exist, but still have a long way to go to become an everyday, personalized healthcare-provisioning tool in the medical field and in a clinical practice. Key main challenge for their widespread adoption involve lack of user acceptance striving from variable credibility and reliability of applications and solutions as they a) lack evidence- based approach; b) have low levels of medical professional involvement in their design and content; c) are provided in an unreliable way, influencing negatively its usability; and, in some cases, d) being industry-driven, hence exposing bias in information provided, for example towards particular types of treatment or intervention procedures.
This paper describes the results of a two year project to design a model curriculum of health care informatics for Dutch higher professional education. The core of the curriculum are sixteen modules which cover the broad range of medical informatics and which are closely related to the profiles of the professions involved (nursing, physiotherapy, speech therapy, occupational therapy and dietetics). The curriculum emphasizes the need of using structured data and information to perform tasks in health care delivery and management, for which modern information technology is indispensable. The model curriculum will enable faculty to redesign existing undergraduate programs and to select the contents they see appropriate. In this way we hope that the model curriculum will contribute to an innovative attitude of future graduating health care professionals. A new three year project just has started to develop learning materials using professional health care software based on the sixteen modules of the curriculum. PMID:8563329
Wageih, Mohamed A; Marcano-Cedeño, Alexis; Gómez, Enrique J; Mantas, John
Biomedical & Health Informatics (BMHI) is relatively new in Arab States. However, several programs/ tracks are running, with high promises of expansion. Programs are evaluated by national authorities, not by a specialized body/association. This does not always mean that the program is of an international standard. One of the possible ways of ensuring the quality of these programs is to be evaluated by international agencies. The International Medical Informatics Association (IMIA) has the expertise in the evaluation BMHI education programs. Accredited programs staffs will have the opportunities for Internationalization and to be engaged with other top-notch organizations, which will have great impacts on the overall implementations of the BMHI in the Arab World. The goal of this document is to show to Arab Universities (pilot: Egypt) how to apply for IMIA Accreditation for their programs.
Daniel, C; Choquet, R
To summarize key contributions to current research in the field of Clinical Research Informatics (CRI) and to select best papers published in 2015. A bibliographic search using a combination of MeSH and free terms search over PubMed on Clinical Research Informatics (CRI) was performed followed by a double-blind review in order to select a list of candidate best papers to be then peer-reviewed by external reviewers. A consensus meeting between the two section editors and the editorial team was finally organized to conclude on the selection of best papers. Among the 579 returned papers published in the past year in the various areas of Clinical Research Informatics (CRI) - i) methods supporting clinical research, ii) data sharing and interoperability, iii) re-use of healthcare data for research, iv) patient recruitment and engagement, v) data privacy, security and regulatory issues and vi) policy and perspectives - the full review process selected four best papers. The first selected paper evaluates the capability of the Clinical Data Interchange Standards Consortium (CDISC) Operational Data Model (ODM) to support the representation of case report forms (in both the design stage and with patient level data) during a complete clinical study lifecycle. The second selected paper describes a prototype for secondary use of electronic health records data captured in non-standardized text. The third selected paper presents a privacy preserving electronic health record linkage tool and the last selected paper describes how big data use in US relies on access to health information governed by varying and often misunderstood legal requirements and ethical considerations. A major trend in the 2015 publications is the analysis of observational, "nonexperimental" information and the potential biases and confounding factors hidden in the data that will have to be carefully taken into account to validate new predictive models. In addiction, researchers have to understand
Demiris, George; Thompson, Hilaire J; Reeder, Blaine; Wilamowska, Katarzyna; Zaslavsky, Oleg
The aim of this paper is to demonstrate how informatics applications can support the assessment and visualization of older adults' wellness. A theoretical framework is presented that informs the design of a technology enhanced screening platform for wellness. We highlight an ongoing pilot demonstration in an assisted living facility where a community room has been converted into a living laboratory for the use of diverse technologies (including a telehealth component to capture vital signs and customized questionnaires, a gait analysis component and cognitive assessment software) to assess the multiple aspects of wellness of older adults. A demonstration project was introduced in an independent retirement community to validate our theoretical framework of informatics and wellness assessment for older adults. Subjects are being recruited to attend a community room and engage in the use of diverse technologies to assess cognitive performance, physiological and gait variables as well as psychometrics pertaining to social and spiritual components of wellness for a period of eight weeks. Data are integrated from various sources into one study database and different visualization approaches are pursued to efficiently display potential correlations between different parameters and capture overall trends of wellness. Preliminary findings indicate that older adults are willing to participate in technology-enhanced interventions and embrace different information technology applications given appropriate and customized training and hardware and software features that address potential functional limitations and inexperience with computers. Informatics can advance health care for older adults and support a holistic assessment of older adults' wellness. The described framework can support decision making, link formal and informal caregiving networks and identify early trends and patterns that if addressed could reduce adverse health events. Copyright © 2011 Elsevier Ireland
Özyer, Tansel; Rokne, Jon; Khoury, Suheil
Crime, terrorism and security are in the forefront of current societal concerns. This edited volume presents research based on social network techniques showing how data from crime and terror networks can be analyzed and how information can be extracted. The topics covered include crime data mining and visualization; organized crime detection; crime network visualization; computational criminology; aspects of terror network analyses and threat prediction including cyberterrorism and the related area of dark web; privacy issues in social networks; security informatics; graph algorithms for soci
This paper outlines a new method of teaching health informatics to large numbers of students from around the world through a Massive Open Online Course (MOOC). The Health Informatics Forum is a social networking site for educating health informatics students and professionals [corrected]. It is running a MOOC for students from around the world that uses creative commons licenced content funded by the US government and developed by five US universities. The content is delivered through narrated lectures with slides that can be viewed online with discussion threads on the forum for class interactions. Students can maintain a professional profile, upload photos and files, write their own blog posts and post discussion threads on the forum. The Health Informatics Forum MOOC has been accessed by 11,316 unique users from 127 countries from August 2, 2012 to January 24, 2014. Most users accessed the MOOC via a desktop computer, followed by tablets and mobile devices and 55% of users were female. Over 400,000 unique users have now accessed the wider Health Informatics Forum since it was established in 2008. Advances in health informatics and educational technology have both created a demand for online learning material in health informatics and a solution for providing it. By using a MOOC delivered through a social networking platform it is hoped that high quality health informatics education will be able to be delivered to a large global audience of future health informaticians without cost.
Full Text Available Background: Pathology informatics is both emerging as a distinct subspecialty and simultaneously becoming deeply integrated within the breadth of pathology practice. As specialists, pathology informaticians need a broad skill set, including aptitude with information fundamentals, information systems, workflow and process, and governance and management. Currently, many of those seeking training in pathology informatics additionally choose training in a second subspecialty. Combining pathology informatics training with molecular pathology is a natural extension, as molecular pathology is a subspecialty with high potential for application of modern biomedical informatics techniques. Methods and Results: Pathology informatics and molecular pathology fellows and faculty evaluated the current fellowship program′s core curriculum topics and subtopics for relevance to molecular pathology. By focusing on the overlap between the two disciplines, a structured curriculum consisting of didactics, operational rotations, and research projects was developed for those fellows interested in both pathology informatics and molecular pathology. Conclusions: The scope of molecular diagnostics is expanding dramatically as technology advances and our understanding of disease extends to the genetic level. Here, we highlight many of the informatics challenges facing molecular pathology today, and outline specific informatics principles necessary for the training of future molecular pathologists.
Li, Ian; Froehlich, Jon; Larsen, Jakob Eg
Personal informatics is a class of systems that help people collect personal information to improve selfknowledge. Improving self-knowledge can foster selfinsight and promote positive behaviors, such as healthy living and energy conservation. The development of personal informatics applications p...
Mandelker, Diana; Lee, Roy E; Platt, Mia Y; Riedlinger, Gregory; Quinn, Andrew; Rao, Luigi K F; Klepeis, Veronica E; Mahowald, Michael; Lane, William J; Beckwith, Bruce A; Baron, Jason M; McClintock, David S; Kuo, Frank C; Lebo, Matthew S; Gilbertson, John R
Pathology informatics is both emerging as a distinct subspecialty and simultaneously becoming deeply integrated within the breadth of pathology practice. As specialists, pathology informaticians need a broad skill set, including aptitude with information fundamentals, information systems, workflow and process, and governance and management. Currently, many of those seeking training in pathology informatics additionally choose training in a second subspecialty. Combining pathology informatics training with molecular pathology is a natural extension, as molecular pathology is a subspecialty with high potential for application of modern biomedical informatics techniques. Pathology informatics and molecular pathology fellows and faculty evaluated the current fellowship program's core curriculum topics and subtopics for relevance to molecular pathology. By focusing on the overlap between the two disciplines, a structured curriculum consisting of didactics, operational rotations, and research projects was developed for those fellows interested in both pathology informatics and molecular pathology. The scope of molecular diagnostics is expanding dramatically as technology advances and our understanding of disease extends to the genetic level. Here, we highlight many of the informatics challenges facing molecular pathology today, and outline specific informatics principles necessary for the training of future molecular pathologists.
C-L. Chang (Chia-Lin); M.J. McAleer (Michael); W.-K. Wong (Wing-Keung)
textabstractThis short communication reviews some of the literature in econometrics and financial economics that is related to informatics and data mining. We then discuss some of the research on econometrics and financial economics that could be extended to informatics and data mining beyond the
Bakoev, Valentin P.
The topic "Recurrence relations" and its place in teaching students of Informatics is discussed in this paper. We represent many arguments about the importance, the necessity and the benefit of studying this subject by Informatics students. They are based on investigation of some fundamental books and textbooks on Discrete Mathematics,…
Over the last decade there is an intensive discussion within the Information Systems (IS) and Informatics community about the characteristics and identity of the discipline. Simultaneously with the discussion, there is an ongoing debate on essential skills and capabilities of IS and Business Informatics graduates as well as the profile of IS…
Giuse, Nunzia B; Williams, Annette M; Giuse, Dario A
The Vanderbilt University paper discusses how the Eskind Biomedical Library at Vanderbilt University Medical Center transitioned from a simplistic approach that linked resources to the institutional electronic medical record system, StarPanel, to a value-added service that is designed to deliver highly relevant information. Clinical teams formulate complex patient-specific questions via an evidence-based medicine literature request basket linked to individual patient records. The paper transitions into discussing how the StarPanel approach acted as a springboard for two additional projects that use highly trained knowledge management librarians with informatics expertise to integrate evidence into both order sets and a patient portal, MyHealth@Vanderbilt.
Farnan, Jeanne M; Snyder Sulmasy, Lois; Worster, Brooke K; Chaudhry, Humayun J; Rhyne, Janelle A; Arora, Vineet M
User-created content and communications on Web-based applications, such as networking sites, media sharing sites, or blog platforms, have dramatically increased in popularity over the past several years, but there has been little policy or guidance on the best practices to inform standards for the professional conduct of physicians in the digital environment. Areas of specific concern include the use of such media for nonclinical purposes, implications for confidentiality, the use of social media in patient education, and how all of this affects the public's trust in physicians as patient-physician interactions extend into the digital environment. Opportunities afforded by online applications represent a new frontier in medicine as physicians and patients become more connected. This position paper from the American College of Physicians and the Federation of State Medical Boards examines and provides recommendations about the influence of social media on the patient-physician relationship, the role of these media in public perception of physician behaviors, and strategies for physician-physician communication that preserve confidentiality while best using these technologies.
Continuing medical education effect on physician knowledge application and psychomotor skills: effectiveness of continuing medical education: American College of Chest Physicians Evidence-Based Educational Guidelines.
O'Neil, Kevin M; Addrizzo-Harris, Doreen J
Recommendations for optimizing continuing medical education (CME) effectiveness in improving physician application of knowledge and psychomotor skills are needed to guide the development of processes that effect physician change and improve patient care. The guideline panel reviewed evidence tables and a comprehensive review of the effectiveness of CME developed by The Johns Hopkins Evidence-based Practice Center for the Agency for Healthcare Research and Quality (AHRQ Evidence Report). The panel considered studies relevant to the effect of CME on physician knowledge application and psychomotor skill development. From the 136 studies identified in the systematic review, 15 articles, 12 addressing physician application of knowledge and 3 addressing psychomotor skills, were identified and reviewed. Recommendations for optimizing CME were developed using the American College of Chest Physicians guideline grading system. The preponderance of evidence demonstrated improvement in physician application of knowledge with CME. The quality of evidence did not allow specific recommendations regarding optimal media or educational techniques or the effectiveness of CME in improving psychomotor skills. CME is effective in improving physician application of knowledge. Multiple exposures and longer durations of CME are recommended to optimize educational outcomes.
Kane, Michael D; Brewer, Jeffrey L
Unprecedented growth in the interdisciplinary domain of biomedical informatics reflects the recent advancements in genomic sequence availability, high-content biotechnology screening systems, as well as the expectations of computational biology to command a leading role in drug discovery and disease characterization. These forces have moved much of life sciences research almost completely into the computational domain. Importantly, educational training in biomedical informatics has been limited to students enrolled in the life sciences curricula, yet much of the skills needed to succeed in biomedical informatics involve or augment training in information technology curricula. This manuscript describes the methods and rationale for training students enrolled in information technology curricula in the field of biomedical informatics, which augments the existing information technology curriculum and provides training on specific subjects in Biomedical Informatics not emphasized in bioinformatics courses offered in life science programs, and does not require prerequisite courses in the life sciences.
Mønsted, Troels Sune
’. Theoretically the project departs from Computer Supported Cooperative Work and Participatory Design and is informed by Medical Informatics, Design Research and Science and Technology Studies. Methodically the project is founded on collaborative prototyping, ethnographic studies, and design interventions...... philosophy and building on theory on narrative reasoning, the dissertation offers the notions of emplotment and re-emplotment to describe how physicians marshal information from various sources, including the medical record, the patient and coSummary to form a narrative, when making sense of patients...
Schieffer, Kathleen M; Peters, Douglas G; Richter, Chesney K; Loc, Welley S; Pawelczyk, James A
As part of the Clinical and Translational Science Institute predoctoral TL1 training program at the Pennsylvania State University, a multidisciplinary team of predoctoral trainees representing the Chemistry, Neurosurgery, Nutritional Sciences, and Public Health Sciences departments were introduced to the NIH-sponsored Informatics for Integrating Biology and the Bedside (i2b2) database to test the following student-generated hypothesis: children with iron deficiency anemia (IDA) are at increased risk of attention deficit-hyperactivity disorder (ADHD). Children aged 4-12 and 4-17 years were categorized into IDA and control groups. De-identified medical records from the Penn State Milton S. Hershey Medical Center (HMC) and the Virginia Commonwealth University Medical Center (VCUMC) were used for the analysis. Overall, ADHD prevalence at each institution was lower than 2011 state estimates. There was a significant association between IDA and ADHD in the 4-17-year-old age group for all children (OR: 1.902 [95% CI: 1.363-2.656]), Caucasian children (OR: 1.802 [95% CI: 1.133-2.864]), and African American children (OR: 1.865 [95% CI: 1.152-3.021]). Clinical and Translational Science Award (CTSA) infrastructure is particularly useful for trainees to answer de novo scientific questions with minimal additional training and technical expertise. Moreover, projects can be expanded by collaborating within the CTSA network. © 2015 Wiley Periodicals, Inc.
Bernstam, Elmer; Meric-Bernstam, Funda; Johnson-Throop, Kathy A.; Turley, James P.; Smith, Jack W.
Clinical and translational research (CTR) is an essential part of a sustainable global health system. Informatics is now recognized as an important en-abler of CTR and informaticians are increasingly called upon to help CTR efforts. The US National Institutes of Health mandated biomedical informatics activity as part of its new national CTR grant initiative, the Clinical and Translational Science Award (CTSA). Traditionally, translational re-search was defined as the translation of laboratory discoveries to patient care (bench to bedside). We argue, however, that there are many other kinds of translational research. Indeed, translational re-search requires the translation of knowledge dis-covered in one domain to another domain and is therefore an information-based activity. In this panel, we will expand upon this view of translational research and present three different examples of translation to illustrate the point: 1) bench to bedside, 2) Earth to space and 3) academia to community. We will conclude with a discussion of our local translational research efforts that draw on each of the three examples.
Nithikathkul, C; Trevanich, A; Wongsaroj, T; Wongsawad, C; Reungsang, P
At the beginning of the new millennium, helminth infections continue to be prevalent, particularly among impoverished populations. This study attempts to create the first health informatics model of helminthiasis in Thailand. The authors investigate how a health informatics model could be used to predict the control and eradication in a national control campaign. Fish-borne helminthiasis caused by Opisthorchis viverrini remains a major public health problem in many parts of South-East Asia, including Thailand, Lao PDR, Vietnam and Cambodia. The epicentre of this disease is located in north-east Thailand, where high prevalence coexists with a high incidence of cholangiocarcinoma (CHCA). The current report was conducted to determine a mathematical model of surveillance for helminthiasis while also using a geographic information system. The fish-borne helminthiasis model or the predicted equation was Y1 = 3.028 + 0.020 (elevation) - 2.098 (clay). For soil-transmitted helminthiasis, the mathematical model or the predicted equation was Y2 = -1.559 + 0.005 (rainfall) + 0.004 (elevation) - 2.198 (clay). The Ministry of Public Health has concluded that mass treatment for helminthiasis in the Thai population, targeting high-risk individuals, may be a cost-effective way to allocate limited funds. This type of approach, as well as further study on the correlation of clinical symptoms with environmental and geographic information, may offer a novel strategy to the helminth crisis.
To explore the founding of the American Medical Association's Section on Surgery in 1859 and how it represented, on a national basis, the beginnings of organized surgery and the formal start of the professionalization and specialization of surgery in the United States. The broad social process of organization, professionalization, and specialization that began for various disciplines in America in the mid-19th century was a reaction to emerging economic, political, and scientific influences including industrialization, urbanization, and technology. For surgeons or, at least, those men who performed surgical operations, the efforts toward group organization provided a means to promote their skills and restrict competition. An analysis of the published literature, and unpublished documents relating to the creation of the American Medical Association's Section on Surgery. During the 1850s and through the 1870s, a time when surgery was still not considered a separate branch of medicine, the organization of the American Medical Association's Section on Surgery provided the much needed encouragement to surgeons in their quest for professional and specialty recognition. The establishment of the American Medical Association's Section on Surgery in 1859 helped shape the nationwide future of the craft, in particular, surgery's rise as a specialty and profession.
Anderson, Norman B; Belar, Cynthia D; Cubic, Barbara A; Garrison, Ellen G; Johnson, Suzanne Bennett; Kaslow, Nadine J
Comments on the article "Joint principles: Integrating behavioral health care into the patient-centered medical home" (see record 2014-24217-011), presented by the Working Party Group on Integrated Behavioral Healthcare. The American Psychological Association (APA) shares concerns about the lack of reference to behavioral health care in the original 2007 Joint Principles of the Patient-Centered Medical Home for which this new document is intended to supplement but not replace. The decision to support the supplemental Joint Principles was not an easy one for APA, as there is one area of significant concern. That concern is related to the use of the term "physician-directed medical practice"
Harmon, Kimberly G; Drezner, Jonathan A; Gammons, Matthew; Guskiewicz, Kevin M; Halstead, Mark; Herring, Stanley A; Kutcher, Jeffrey S; Pana, Andrea; Putukian, Margot; Roberts, William O
helpful in the post-concussion management of athletes with persistent symptoms or complicated courses. ▸ Students will require cognitive rest and may require academic accommodations such as reduced workload and extended time for tests while recovering from a concussion. ▸ Concussion symptoms should be resolved before returning to exercise. ▸ A RTP progression involves a gradual, step-wise increase in physical demands, sports-specific activities and the risk for contact. ▸ If symptoms occur with activity, the progression should be halted and restarted at the preceding symptom-free step. ▸ RTP after concussion should occur only with medical clearance from a licenced healthcare provider trained in the evaluation and management of concussions. SHORT-TERM RISKS OF PREMATURE RTP: ▸ The primary concern with early RTP is decreased reaction time leading to an increased risk of a repeat concussion or other injury and prolongation of symptoms. LONG-TERM EFFECTS: ▸ There is an increasing concern that head impact exposure and recurrent concussions contribute to long-term neurological sequelae. ▸ Some studies have suggested an association between prior concussions and chronic cognitive dysfunction. Large-scale epidemiological studies are needed to more clearly define risk factors and causation of any long-term neurological impairment. ▸ There are no evidence-based guidelines for disqualifying/retiring an athlete from a sport after a concussion. Each case should be carefully deliberated and an individualised approach to determining disqualification taken. ▸ Greater efforts are needed to educate involved parties, including athletes, parents, coaches, officials, school administrators and healthcare providers to improve concussion recognition, management and prevention. ▸ Physicians should be prepared to provide counselling regarding potential long-term consequences of a concussion and recurrent concussions. ▸ Primary prevention of some injuries may be possible with
Stark, Paul C; Kalenderian, Elsbeth; White, Joel M; Walji, Muhammad F; Stewart, Denice C L; Kimmes, Nicole; Meng, Thomas R; Willis, George P; DeVries, Ted; Chapman, Robert J
Advances in informatics, particularly the implementation of electronic health records (EHR), in dentistry have facilitated the exchange of information. The majority of dental schools in North America use the same EHR system, providing an unprecedented opportunity to integrate these data into a repository that can be used for oral health education and research. In 2007, fourteen dental schools formed the Consortium for Oral Health-Related Informatics (COHRI). Since its inception, COHRI has established structural and operational processes, governance and bylaws, and a number of work groups organized in two divisions: one focused on research (data standardization, integration, and analysis), and one focused on education (performance evaluations, virtual standardized patients, and objective structured clinical examinations). To date, COHRI (which now includes twenty dental schools) has been successful in developing a data repository, pilot-testing data integration, and sharing EHR enhancements among the group. This consortium has collaborated on standardizing medical and dental histories, developing diagnostic terminology, and promoting the utilization of informatics in dental education. The consortium is in the process of assembling the largest oral health database ever created. This will be an invaluable resource for research and provide a foundation for evidence-based dentistry for years to come.
A review of the current challenges, trends and initiatives around the various regulations as related to Health Informatics in the United States is presented. A summary of the functions in a workflow-based approach organized into the process and compliance for HIPAA, secure email and fax communications interfaces, e-prescriptions and patient safety and the health information technology savings claims versus costs follows: HIPAA compliance is complex; data interoperability and integration remains difficult.Email and faxing is possible with current over-the-shelf technologies within the purview of the HIPAA Security and Privacy rule.Integration of e-prescribing and NPI data is an area where health informatics can make a real difference.Medical errors remain high.There are no real savings yet from the usage of health information technologies; the costs for implementation remain high, and the business model has not evolved to meet the needs.Health Information Technology (Health IT) projects continue to have a significant failure rate; Open Source technologies are a viable alternative both for cost reduction and scalability. A discussion on the macro view of health informatics is also presented within the context of healthcare models and a comparison of the U.S. system against other countries.
Full Text Available A review of the current challenges, trends and initiatives around the various regulations as related to Health Informatics in the United States is presented.A summary of the functions in a workflow-based approach organized into the process and compliance for HIPAA, secure email and fax communications interfaces, e-prescriptions and patient safety and the health information technology savings claims versus costs follows: * HIPAA compliance is complex; data interoperability and integration remains difficult. * Email and faxing is possible with current over-the-shelf technologies within the purview of the HIPAA Security and Privacy rule. * Integration of e-prescribing and NPI data is an area where health informatics can make a real difference. * Medical errors remain high. * There are no real savings yet from the usage of health information technologies; the costs for implementation remain high, and the business model has not evolved to meet the needs. * Health Information Technology (Health IT projects continue to have a significant failure rate; Open Source technologies are a viable alternative both for cost reduction and scalability.A discussion on the macro view of health informatics is also presented within the context of healthcare models and a comparison of the U.S. system against other countries.
Staccini, P; Douali, N
To provide an overview of outstanding current research conducted in Education and Consumer Informatics. Synopsis of the articles on education and consumer health informatics published in 2012 and selected for the IMIA Yearbook of Medical Informatics 2013. Architecture of monitoring or telehealth information systems for patients with chronic disease must include wireless devices to aid in the collection of personal data. Data acquisition technologies have an impact on patients' willingness to participate in telehealth programmes. Patients are more likely to prefer mobile applications over web-based applications. Social media is widely used by clinicians. Especially younger clinicians use it for personal purposes and for reference materials retrieval. Questions remain on optimal training requirements and on the effects on clinician behavior and on patient outcomes. A high level of e-Health literacy by patients will promote increased adoption and utilization of personal health records. The selected articles highlight the need for training of clinicians to become aware of existing telehealth systems, in order to correctly inform and guide patients to take part in telehealth systems and adopt personal healthcare records (PHR).
Palmisano, Donald J; Emmons, David W; Wozniak, Gregory D
Recent reports showing an increase in the number of uninsured individuals in the United States have given heightened attention to increasing health insurance coverage. The American Medical Association (AMA) has proposed a system of tax credits for the purchase of individually owned health insurance and enhancements to individual and group health insurance markets as a means of expanding coverage. Individually owned insurance would enable people to maintain coverage without disruption to existing patient-physician relationships, regardless of changes in employers or in work status. The AMA's plan would empower individuals to choose their health plan and give patients and their physicians more control over health care choices. Employers could continue to offer employment-based coverage, but employees would not be limited to the health plans offered by their employer. With a tax credit large enough to make coverage affordable and the ability to choose their own coverage, consumers would dramatically transform the individual and group health insurance markets. Health insurers would respond to the demands of individual consumers and be more cautious about increasing premiums. Insurers would also tailor benefit packages and develop new forms of coverage to better match the preferences of individuals and families. The AMA supports the development of new health insurance markets through legislative and regulatory changes to foster a wider array of high-quality, affordable plans.
Park, Seung; Parwani, Anil V.; Aller, Raymond D.; Banach, Lech; Becich, Michael J.; Borkenfeld, Stephan; Carter, Alexis B.; Friedman, Bruce A.; Rojo, Marcial Garcia; Georgiou, Andrew; Kayser, Gian; Kayser, Klaus; Legg, Michael; Naugler, Christopher; Sawai, Takashi; Weiner, Hal; Winsten, Dennis; Pantanowitz, Liron
Pathology informatics has evolved to varying levels around the world. The history of pathology informatics in different countries is a tale with many dimensions. At first glance, it is the familiar story of individuals solving problems that arise in their clinical practice to enhance efficiency, better manage (e.g., digitize) laboratory information, as well as exploit emerging information technologies. Under the surface, however, lie powerful resource, regulatory, and societal forces that helped shape our discipline into what it is today. In this monograph, for the first time in the history of our discipline, we collectively perform a global review of the field of pathology informatics. In doing so, we illustrate how general far-reaching trends such as the advent of computers, the Internet and digital imaging have affected pathology informatics in the world at large. Major drivers in the field included the need for pathologists to comply with national standards for health information technology and telepathology applications to meet the scarcity of pathology services and trained people in certain countries. Following trials by a multitude of investigators, not all of them successful, it is apparent that innovation alone did not assure the success of many informatics tools and solutions. Common, ongoing barriers to the widespread adoption of informatics devices include poor information technology infrastructure in undeveloped areas, the cost of technology, and regulatory issues. This review offers a deeper understanding of how pathology informatics historically developed and provides insights into what the promising future might hold. PMID:23869286
Zsakó, László; Horváth, Gyozo
Informatics education has been in a cul-de-sac for several years (not only in Hungary), being less and less able to meet the needs of the industry and higher education. In addition, the latest PISA survey shows that--to put it a little strongly--the majority of the x-, y- and z generations are digital illiterates. The aim of this paper to examine…
O'Connor, Siobhan; Hubner, Ursula; Shaw, Toria; Blake, Rachelle; Ball, Marion
Information Technology (IT) continues to evolve and develop with electronic devices and systems becoming integral to healthcare in every country. This has led to an urgent need for all professions working in healthcare to be knowledgeable and skilled in informatics. The Technology Informatics Guiding Education Reform (TIGER) Initiative was established in 2006 in the United States to develop key areas of informatics in nursing. One of these was to integrate informatics competencies into nursing curricula and life-long learning. In 2009, TIGER developed an informatics competency framework which outlines numerous IT competencies required for professional practice and this work helped increase the emphasis of informatics in nursing education standards in the United States. In 2012, TIGER expanded to the international community to help synthesise informatics competencies for nurses and pool educational resources in health IT. This transition led to a new interprofessional, interdisciplinary approach, as health informatics education needs to expand to other clinical fields and beyond. In tandem, a European Union (EU) - United States (US) Collaboration on eHealth began a strand of work which focuses on developing the IT skills of the health workforce to ensure technology can be adopted and applied in healthcare. One initiative within this is the EU*US eHealth Work Project, which started in 2016 and is mapping the current structure and gaps in health IT skills and training needs globally. It aims to increase educational opportunities by developing a model for open and scalable access to eHealth training programmes. With this renewed initiative to incorporate informatics into the education and training of nurses and other health professionals globally, it is time for educators, researchers, practitioners and policy makers to join in and ROAR with TIGER. Copyright © 2017 Elsevier Ltd. All rights reserved.
Noh, Jung Ho
The contents of this book are competition of mental weakness and visually handicapped people, barbarian about the knowledge of commodity, we are living in notion of time of the agricultural age, parade of informatization of fool. Is there a successful case of informatization when it is done as others do?, what is technology of informatization?, there is mistake in traditional information technology from a system of thought, information system, and analysis of improvement of industrial structure case of development for program case of system installation, and a thief free society.
Noh, Jung Ho
The contents of this book are competition of mental weakness and visually handicapped people, barbarian about the knowledge of commodity, we are living in notion of time of the agricultural age, parade of informatization of fool. Is there a successful case of informatization when it is done as others do?, what is technology of informatization?, there is mistake in traditional information technology from a system of thought, information system, and analysis of improvement of industrial structure case of development for program case of system installation, and a thief free society.
Kennedy, Margaret Ann; Moen, Anne
Nurse leaders must demonstrate capacities and develop specific informatics competencies in order to provide meaningful leadership and support ongoing transformation of the healthcare system. Concurrently, staff informatics competencies must be planned and fostered to support critical principles of transformation and patient safety in practice, advance evidence-informed practice, and enable nursing to flourish in complex digital environments across the healthcare continuum. In addition to nurse leader competencies, two key aspects of leadership and informatics competencies will be addressed in this chapter - namely, the transformation of health care and preparation of the nursing workforce.
Shaalan, Khaled; Gaber, Tarek; Azar, Ahmad; Tolba, M
This book gathers the proceedings of the 2nd International Conference on Advanced Intelligent Systems and Informatics (AISI2016), which took place in Cairo, Egypt during October 24–26, 2016. This international interdisciplinary conference, which highlighted essential research and developments in the field of informatics and intelligent systems, was organized by the Scientific Research Group in Egypt (SRGE) and sponsored by the IEEE Computational Intelligence Society (Egypt chapter) and the IEEE Robotics and Automation Society (Egypt Chapter). The book’s content is divided into four main sections: Intelligent Language Processing, Intelligent Systems, Intelligent Robotics Systems, and Informatics.
Hashimoto, Kiyota; Iwamoto, Hidekazu
This book introduces new trends of theory and practice of information technologies in tourism. The book does not handle only the fundamental contribution, but also discusses innovative and emerging technologies to promote and develop new generation tourism informatics theory and their applications. Some chapters are concerned with data analysis, web technologies, social media, and their case studies. Travel information on the web provided by travelers is very useful for other travelers make their travel plan. A chapter in this book proposes a method for interactive retrieval of information on accommodation facilities to support travelling customers in their travel preparations. Also an adaptive user interface for personalized transportation guidance system is proposed. Another chapter in this book shows a novel support system for the collaborative tourism planning by using the case reports that are collected via Internet. Also, a system for recommending hotels for the users is proposed and evaluated. Other ch...
Broderick, Scott; Rajan, Krishna
In this review, we provide an overview of the development of quantitative structure–property relationships incorporating the impact of data uncertainty from small, limited knowledge data sets from which we rapidly develop new and larger databases. Unlike traditional database development, this informatics based approach is concurrent with the identification and discovery of the key metrics controlling structure–property relationships; and even more importantly we are now in a position to build materials databases based on design ‘intent’ and not just design parameters. This permits for example to establish materials databases that can be used for targeted multifunctional properties and not just one characteristic at a time as is presently done. This review provides a summary of the computational logic of building such virtual databases and gives some examples in the field of complex inorganic solids for scintillator applications. (review)
Sboner, Andrea; Elemento, Olivier
In this review, we describe key components of a computational infrastructure for a precision medicine program that is based on clinical-grade genomic sequencing. Specific aspects covered in this review include software components and hardware infrastructure, reporting, integration into Electronic Health Records for routine clinical use and regulatory aspects. We emphasize informatics components related to reproducibility and reliability in genomic testing, regulatory compliance, traceability and documentation of processes, integration into clinical workflows, privacy requirements, prioritization and interpretation of results to report based on clinical needs, rapidly evolving knowledge base of genomic alterations and clinical treatments and return of results in a timely and predictable fashion. We also seek to differentiate between the use of precision medicine in germline and cancer. © The Author 2015. Published by Oxford University Press. For Permissions, please email: firstname.lastname@example.org.
Full Text Available This pilot initiative uses an approach that focuses on improving the whole business of primary care, its processes and its people. The Health Informatics Programme for Coronary Heart Disease (HIP for CHD addresses the two faces of clinical governance but has a prime focus on the development of learning organisations. The project has developed a methodology and an associated set of tools that it has tested and evaluated in a small number of pilot sites. The work of HIP for CHD is focused on coronary heart disease but the methodology is equally applicable to other clinical areas. In particular, HIP for CHD provides an approach that allows the diverse strands of all of the National Service Frameworks to be handled in a joined-up way in primary care.
Nordstrom, Kimberly; Zun, Leslie S; Wilson, Michael P; MD, Victor Stiebel; Ng, Anthony T; Bregman, Benjamin; Anderson, Eric L
Numerous medical and psychiatric conditions can cause agitation; some of these causes are life threatening. It is important to be able to differentiate between medical and nonmedical causes of agitation so that patients can receive appropriate and timely treatment. This article aims to educate all clinicians in nonmedical settings, such as mental health clinics, and medical settings on the differing levels of severity in agitation, basic triage, use of de-escalation, and factors, symptoms, and signs in determining whether a medical etiology is likely. Lastly, this article focuses on the medical workup of agitation when a medical etiology is suspected or when etiology is unclear. PMID:22461915
Cushing, J.B.; Wilson, T.; Borning, A.; Delcambre, L.; Bowker, G.; Frame, M.; Schnase, J.; Sonntag, W.; Fulop, J.; Hert, C.; Hovy, E.; Jones, J.; Landis, E.; Schweik, C.; Brandt, L.; Gregg, V.; Spengler, S.
This project highlight reports on the 2004 workshop , as well as follow-up activities in 2005 and 2006, regarding how informatics tools can help manage natural resources and decide policy. The workshop was sponsored jointly by sponsored by the NSF, NBII, NASA, and EPA, and attended by practitioners from government and non-government agencies, and university researchers from the computer, social, and ecological sciences. The workshop presented the significant information technology (IT) problems that resource managers face when integrating ecological or environmental information to make decisions. These IT problems fall into five categories: data presentation, data gaps, tools, indicators, and policy making and implementation. To alleviate such problems, we recommend informatics research in four IT areas, as defined in this abstract and our final report: modeling and simulation, data quality, information integration and ontologies, and social and human aspects. Additionally, we recommend that funding agencies provide infrastructure and some changes in funding habits to assure cycles of innovation in the domain were addressed. Follow-on activities to the workshop subsequent to dg.o 2005 included: an invited talk presenting workshop results at DILS 2005, publication of the workshop final report by the NBII , and a poster at the NBII All Hands Meeting (Oct. 2005). We also expect a special issue of the JIIS to appear in 2006 that addresses some of these questions. As we go to press, no solicitation by funding agencies has as yet been published, but various NASA and NBII, and NSF cyber-infrastructure and DG research efforts now underway address the above issues.
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Dennis, Matthew J; Bennett, Jeffrey D; DeLuke, Dean M; Evans, Erik W; Hudson, John W; Nattestad, Anders; Ness, Gregory M; Yeung, Allison
Dental procedures are often performed on patients who present with some level of medical fragility. In many dental schools, the exercise of taking a medical history is all too often a transcription of information to the dental chart, with little emphasis on the presurgical risk assessment and the development of a treatment plan appropriate to the medical status of the dental patient. Changes in dentistry, driven by an increasingly medically complex population of dental patients, combined with treatment advances rooted in the biomedical sciences necessitate the adaptation of our dental education to include a stronger background in systemic health. Many predoctoral educators in the American Association of Oral and Maxillofacial Surgeons (AAOMS) have expressed concern about the medical preparedness of our dental students; therefore, the AAOMS and its Committee on Predoctoral Education and Training have provided recommendations for improving the medical curriculum in predoctoral dental education, including a strengthening of training in clinical medicine and biomedical sciences, with specific recommendations for improved training of our dental students and dental faculty. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Full Text Available Numerous medical and psychiatric conditions can cause agitation, some of these causes are life threatening. It is important to be able to differentiate between medical and non-medical causes of agitation so that patients can receive appropriate and timely treatment. This article aims to educate all clinicians in non-medical settings, such as mental health clinics, and medical settings on the differing levels of severity in agitation, basic triage, use of de-escalation, and factors, symptoms, and signs in determining whether a medical etiology is likely. Lastly, this article focuses on the medical workup of agitation when a medical etiology is suspected or when etiology is unclear. [West J Emerg Med. 2012;13(1:3–10.
Weng, C; Kahn, M G
To reflect on the notable events and significant developments in Clinical Research Informatics (CRI) in the year of 2015 and discuss near-term trends impacting CRI. We selected key publications that highlight not only important recent advances in CRI but also notable events likely to have significant impact on CRI activities over the next few years or longer, and consulted the discussions in relevant scientific communities and an online living textbook for modern clinical trials. We also related the new concepts with old problems to improve the continuity of CRI research. The highlights in CRI in 2015 include the growing adoption of electronic health records (EHR), the rapid development of regional, national, and global clinical data research networks for using EHR data to integrate scalable clinical research with clinical care and generate robust medical evidence. Data quality, integration, and fusion, data access by researchers, study transparency, results reproducibility, and infrastructure sustainability are persistent challenges. The advances in Big Data Analytics and Internet technologies together with the engagement of citizens in sciences are shaping the global clinical research enterprise, which is getting more open and increasingly stakeholder-centered, where stakeholders include patients, clinicians, researchers, and sponsors.
Markowetz, Alexander; Błaszkiewicz, Konrad; Montag, Christian; Switala, Christina; Schlaepfer, Thomas E
For the first time in history, it is possible to study human behavior on great scale and in fine detail simultaneously. Online services and ubiquitous computational devices, such as smartphones and modern cars, record our everyday activity. The resulting Big Data offers unprecedented opportunities for tracking and analyzing behavior. This paper hypothesizes the applicability and impact of Big Data technologies in the context of psychometrics both for research and clinical applications. It first outlines the state of the art, including the severe shortcomings with respect to quality and quantity of the resulting data. It then presents a technological vision, comprised of (i) numerous data sources such as mobile devices and sensors, (ii) a central data store, and (iii) an analytical platform, employing techniques from data mining and machine learning. To further illustrate the dramatic benefits of the proposed methodologies, the paper then outlines two current projects, logging and analyzing smartphone usage. One such study attempts to thereby quantify severity of major depression dynamically; the other investigates (mobile) Internet Addiction. Finally, the paper addresses some of the ethical issues inherent to Big Data technologies. In summary, the proposed approach is about to induce the single biggest methodological shift since the beginning of psychology or psychiatry. The resulting range of applications will dramatically shape the daily routines of researches and medical practitioners alike. Indeed, transferring techniques from computer science to psychiatry and psychology is about to establish Psycho-Informatics, an entire research direction of its own. Copyright © 2013 Elsevier Ltd. All rights reserved.
Peisert, Sean; Barnett, William; Dart, Eli; Cuff, James; Grossman, Robert L; Balas, Edward; Berman, Ari; Shankar, Anurag; Tierney, Brian
meeting regulatory requirements. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association.
Susannah Tringe of the DOE Joint Genome Institute talks about the Program Overview and Program Informatics at the Metagenomics Informatics Challenges Workshop held at the DOE JGI on October 12-13, 2011.
Mora, Patricia; Blanco, Susana; Khoury, Helen; Leyton, Fernando; Cardenas, Juan; Defaz, Maria Yolanda; Garay, Fernando; Telon, Flaviano; Garcia Aguilar, Juan; Roas, Norma; Gamarra, Mirtha; Blanco, Daniel; Quintero, Ana Rosa; Nader, Alejandro
Latin American countries (Argentina, Brazil, Chile, Costa Rica, Cuba, Ecuador, El Salvador, Guatemala, Mexico, Nicaragua, Paraguay, Uruguay and Venezuela) working under the International Atomic Energy Agency (IAEA) Technical Cooperation Programme: TSA3 Radiological Protection of Patients in Medical Exposures have joined efforts in the optimisation of radiation protection in mammography practice. Through surveys of patient doses, the region has a unique database of diagnostic reference levels for analogue and digital equipment that will direct future optimisation activities towards the early detection of breast cancer among asymptomatic women. During RLA9/057 (2007-09) 24 institutions participated with analogue equipment in a dose survey. Regional training on methodology and measurement equipment was addressed in May 2007. The mean glandular dose (DG) was estimated using the incident kerma in air and relevant conversion coefficients for both projections craneo caudal and mediolateral oblique (CC and MLO). For Phase 2, RLA9/067 (2010-11), it was decided to include also digital systems in order to see their impact in future dose optimisation activities. Any new country that joined the project received training in the activities through IAEA expert missions. Twenty-nine new institutions participated (9 analogue and 20 digital equipment). A total of 2262 patient doses were collected during this study and from them D G (mGy) for both projections were estimated for each institution and country. Regional results (75 percentile in mGy) show for CC and MLO views, respectively: RLA9/057 (analogue) 2.63 and 3.17; RLA/067: 2.57 and 3.15 (analogue) and 2.69 and 2.90 (digital). Regarding only digital equipment for CC and MLO, respectively, computed radiography systems showed 2.59 and 2.78 and direct digital radiography (DDR) systems 2.78 and 3.04. Based on the IAEA Basic Safety Standard (BSS) reference dose (3 mGy), it can be observed that there is enough room to start
Mora, Patricia; Blanco, Susana; Khoury, Helen; Leyton, Fernando; Cárdenas, Juan; Defaz, María Yolanda; Garay, Fernando; Telón, Flaviano; Aguilar, Juan Garcia; Roas, Norma; Gamarra, Mirtha; Blanco, Daniel; Quintero, Ana Rosa; Nader, Alejandro
Latin American countries (Argentina, Brazil, Chile, Costa Rica, Cuba, Ecuador, El Salvador, Guatemala, Mexico, Nicaragua, Paraguay, Uruguay and Venezuela) working under the International Atomic Energy Agency (IAEA) Technical Cooperation Programme: TSA3 Radiological Protection of Patients in Medical Exposures have joined efforts in the optimisation of radiation protection in mammography practice. Through surveys of patient doses, the region has a unique database of diagnostic reference levels for analogue and digital equipment that will direct future optimisation activities towards the early detection of breast cancer among asymptomatic women. During RLA9/057 (2007-09) 24 institutions participated with analogue equipment in a dose survey. Regional training on methodology and measurement equipment was addressed in May 2007. The mean glandular dose (DG) was estimated using the incident kerma in air and relevant conversion coefficients for both projections craneo caudal and mediolateral oblique (CC and MLO). For Phase 2, RLA9/067 (2010-11), it was decided to include also digital systems in order to see their impact in future dose optimisation activities. Any new country that joined the project received training in the activities through IAEA expert missions. Twenty-nine new institutions participated (9 analogue and 20 digital equipment). A total of 2262 patient doses were collected during this study and from them D(G) (mGy) for both projections were estimated for each institution and country. Regional results (75 percentile in mGy) show for CC and MLO views, respectively: RLA9/057 (analogue) 2.63 and 3.17; RLA/067: 2.57 and 3.15 (analogue) and 2.69 and 2.90 (digital). Regarding only digital equipment for CC and MLO, respectively, computed radiography systems showed 2.59 and 2.78 and direct digital radiography (DDR) systems 2.78 and 3.04. Based on the IAEA Basic Safety Standard (BSS) reference dose (3 mGy), it can be observed that there is enough room to start
Informatics is about information and its processing, also known as computation. Nowadays, children grow up taking smartphones and the internet for granted. Information and computation rule society. Science uses computerized equipment to collect, analyze, and visualize massive amounts of data.
In this paper author deals with next problems of Slovenske elektrarne, Plc (SE): - Centralisation and optimisation of informatics management; - New technologies within Integrated Informatics System IIS-SE: presentation of preliminary Project of 2 nd generation IIS-SE; - Centralisation of the selected data processing. At the present the intensive process of restructuring is taking place in SE, Plc, focused on increasing of the effectiveness of the pursued activities. In connection with this the Informatics section solves two projects: More effective self-management and human resources; Change of Informatics system architecture from decentralised to the centralised ones with an aim to consolidate all information and to make new conditions for higher mobility. (author)
Monteleoni, Claire; Schmidt, Gavin A.; McQuade, Scott
The goal of climate informatics, an emerging discipline, is to inspire collaboration between climate scientists and data scientists, in order to develop tools to analyze complex and ever-growing amounts of observed and simulated climate data, and thereby bridge the gap between data and understanding. Here, recent climate informatics work is presented, along with details of some of the field's remaining challenges. Given the impact of climate change, understanding the climate system is an international priority. The goal of climate informatics is to inspire collaboration between climate scientists and data scientists, in order to develop tools to analyze complex and ever-growing amounts of observed and simulated climate data, and thereby bridge the gap between data and understanding. Here, recent climate informatics work is presented, along with details of some of the remaining challenges.
Despite the growing interest by leaders, policy makers, and others, the terminology of health information technology as well as biomedical and health informatics is poorly understood and not even agreed upon by academics and professionals in the field. The paper, presented as a Debate to encourage further discussion and disagreement, provides definitions of the major terminology used in biomedical and health informatics and health information technology. For informatics, it focuses on the words that modify the term as well as individuals who practice the discipline. Other categories of related terms are covered as well, from the associated disciplines of computer science, information technology and health information management to the major application categories of applications used. The discussion closes with a classification of individuals who work in the largest segment of the field, namely clinical informatics. The goal of presenting in Debate format is to provide a starting point for discussion to reach a documented consensus on the definition and use of these terms.
Nursing informatics education and use: challenges and prospects in Nigeria. ... that training in NI is critical in the delivery of safe and quality patient care. ... Director of Nursing Services and Principals as well as Nursing associations like ...
Mohapatra, Durga; Konar, Amit; Chakraborty, Aruna
Advanced Computing, Networking and Informatics are three distinct and mutually exclusive disciplines of knowledge with no apparent sharing/overlap among them. However, their convergence is observed in many real world applications, including cyber-security, internet banking, healthcare, sensor networks, cognitive radio, pervasive computing amidst many others. This two-volume proceedings explore the combined use of Advanced Computing and Informatics in the next generation wireless networks and security, signal and image processing, ontology and human-computer interfaces (HCI). The two volumes together include 148 scholarly papers, which have been accepted for presentation from over 640 submissions in the second International Conference on Advanced Computing, Networking and Informatics, 2014, held in Kolkata, India during June 24-26, 2014. The first volume includes innovative computing techniques and relevant research results in informatics with selective applications in pattern recognition, signal/image process...
Full Text Available The paper contains issues regarding: main characteristics and examples of the distributed informatics systems and main difference categories among them, concepts, principles, techniques and fields for auditing the distributed informatics systems, concepts and classes of the standard term, characteristics of this one, examples of standards, guidelines, procedures and controls for auditing the distributed informatics systems. The distributed informatics systems are characterized by the following issues: development process, resources, implemented functionalities, architectures, system classes, particularities. The audit framework has two sides: the audit process and auditors. The audit process must be led in accordance with the standard specifications in the IT&C field. The auditors must meet the ethical principles and they must have a high-level of professional skills and competence in IT&C field.
Palma, Jonathan P.; Benitz, William E.; Tarczy-Hornoch, Peter; Butte, Atul J.; Longhurst, Christopher A.
The future of neonatal informatics will be driven by the availability of increasingly vast amounts of clinical and genetic data. The field of translational bioinformatics is concerned with linking and learning from these data and applying new findings to clinical care to transform the data into proactive, predictive, preventive, and participatory health. As a result of advances in translational informatics, the care of neonates will become more data driven, evidence based, and personalized. PMID:22924023
Full Text Available in informatization programs are approached: criteria of efficiency, general problem, aggregate problem in continuous form, general problem in discrete form and solving of problems. As criterion of informatization projects' economic efficiency, the total profit maximization due to investments is used. In preliminary calculations, the opportunity of considering continuous dependences of profit on the volume of investments by domain activities is grounded. Eleven classes of such dependences are investigated and analytical solutions and algorithms for solving formulated problems are described.
Evaluation of health informatics technology has had attention from quite a few researchers in health informatics in the last few decades. In the early nineties of the past century several working groups and research projects have discussed evaluation methods and methodologies. Despite these activities, evaluation of health informatics has not received the recognition it deserves. In this presentation we will reiterate the arguments put forward in the Declaration of Innsbruck to consider evaluation an essential element of the evidence base of health informatics. Not only are evaluation studies essential, it is also required that such studies are properly reported. A joint effort of the IMIA, EFMI and AMIA working groups on evaluation has resulted in a guideline for reporting the results of evaluation studies of health informatics applications (STARE-HI). STARE-HI is currently endorsed by EFMI. The general assembly of IMIA has adopted STARE-HI as an official IMIA document. Endorsement from AMIA is being sought. A pilot study in which STARE-HI was applied to assess the quality of current reporting clearly indicates that there is quite some room for improvement. Application of guidelines such as STARE-HI would contribute to a further improvement of the evidence base of health informatics and would open the road for high quality reviews and meta-analyses.
Andrew J. Cole
Full Text Available There is a lack of data analyzing the influence of cardiovascular disease (CVD risk factor control on graft survival disparities in African-American kidney transplant recipients. Studies in the general population indicate that CVD risk factor control is poor in African-Americans, leading to higher rates of renal failure and major acute cardiovascular events. However, with the exception of hypertension, there is no data demonstrating similar results within transplant recipients. Recent analyses conducted by our investigator group indicate that CVD risk factors, especially diabetes, are poorly controlled in African-American recipients, which likely impacts graft loss. This study protocol describes a prospective interventional clinical trial with the goal of demonstrating improved medication safety and CVD risk factor control in adult solitary kidney transplant recipients at least one-year post-transplant with a functioning graft. This is a prospective, interventional, 6-month, pharmacist-led and technology enabled study in adult kidney transplant recipients with the goal of improving CVD risk factor outcomes by improving medication safety and patient self-efficacy. This papers describes the issues related to racial disparities in transplant, the details of this intervention and how we expect this intervention to improve CVD risk factor control in kidney transplant recipients, particularly within African-Americans.
Freudenberg, W; Ohya, M
The purpose of this volume is examine bio-informatics and quantum information, which are growing rapidly at present, and to attempt to connect the two, with a view to enumerating and solving the many fundamental problems they entail. To this end, we look for interdisciplinary bridges in mathematics, physics, and information and life sciences. In particular, research into a new paradigm for information science and life science on the basis of quantum theory is emphasized. Sample Chapter(s). Markov Fields on Graphs (599 KB). Contents: Markov Fields on Graphs (L Accardi & H Ohno); Some Aspects of
Oyri, Karl; Murray, Peter J
Many health informatics organizations seem to be slow to take up the advantages of dynamic, web-based technologies for providing services to, and interaction with, their members; these are often the very technologies they promote for use within healthcare environments. This paper aims to introduce some of the many free/libre/open source (FLOSS) applications that are now available to develop interactive websites and dynamic online communities as part of the structure of health informatics organizations, and to show how the Open Source Nursing Informatics Working Group (OSNI) of the special interest group in nursing informatics of the International Medical Informatics Association (IMIA-NI) is using some of these tools to develop an online community of nurse informaticians through their website, at . Some background introduction to FLOSS applications is used for the benefit of those less familiar with such tools, and examples of some of the FLOSS content management systems (CMS) being used by OSNI are described. The experiences of the OSNI will facilitate a knowledgeable nursing contribution to the wider discussions on the applications of FLOSS within health and healthcare, and provides a model that many other groups could adopt.
Valera, Pamela; McClernon, F Joseph; Burkholder, Greer; Mugavero, Michael J; Willig, James; O'Cleirigh, Conall; Cropsey, Karen L
Algorithm-based treatments (AT) may be an effective clinical tool to aid HIV clinicians in prescribing pharmacotherapy to increase smoking cessation among people living with HIV (PLWH). Initial results from AT indicated significant increases in abstinence self-efficacy and medication utilization and declines in cigarettes smoked per day across time. Given historical racial disparities, it is unclear if both African Americans and White smokers would benefit equally from this type of intervention. Thus, the aim of this study was to examine racial differences in response to AT guided smoking cessation for African American and White smokers living with HIV. One hundred PLWH smokers (n = 100) were randomized to receive either AT guided smoking cessation or Treatment as Usual (TAU) which consisted of instructing participants to talk to a provider about smoking cessation assistance when ready to make a quit attempt. Participants were African American (75%) and White (25%) and majority men (71%) who had never been married (56%). African Americans smoked fewer cigarettes and were more likely to smoke mentholated cigarettes compared to White smokers at baseline. African Americans increased their use of other tobacco products (cigars/cigarillos) over time relative to White smokers. A significant interaction between race and quit goal was observed, with White smokers who reported complete abstinence as their goal having higher quit rates, while African Americans who reported a goal other than complete abstinence demonstrating higher quit rates. The increased use of cigars/cigarillos during quit attempts as well as having a goal other than complete abstinence should be considered when applying algorithm based interventions for PLWH African American smokers.
Kolmodin MacDonell, Karen; Naar, Sylvie; Gibson-Scipio, Wanda; Lam, Phebe; Secord, Elizabeth
To conduct a randomized controlled pilot of a multicomponent, technology-based intervention promoting adherence to controller medication in African-American emerging adults with asthma. The intervention consisted of two computer-delivered sessions based on motivational interviewing combined with text messaged reminders between sessions. Participants (N = 49) were 18-29 years old, African-American, with persistent asthma requiring controller medication. Participants had to report poor medication adherence and asthma control. Youth were randomized to receive the intervention or an attention control. Data were collected through computer-delivered self-report questionnaires at baseline, 1, and 3 months. Ecological Momentary Assessment via two-way text messaging was also used to collect "real-time" data on medication use and asthma control. The intervention was feasible and acceptable to the target population, as evidenced by high retention rates and satisfaction scores. Changes in study outcomes from pre- to postintervention favored the intervention, particularly for decrease in asthma symptoms, t (42) = 2.22, p < .05 (Cohen's d = .071). Results suggest that the intervention is feasible and effective. However, findings are preliminary and should be replicated with a larger sample and more sophisticated data analyses. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY DISEASE STATE CLINICAL REVIEW: MANAGEMENT OF ACROMEGALY PATIENTS: WHAT IS THE ROLE OF PRE-OPERATIVE MEDICAL THERAPY?
Fleseriu, Maria; Hoffman, Andrew R; Katznelson, Laurence
Acromegaly is a complex disease characterized by growth hormone (GH) excess originating in most cases from a pituitary tumor. The goals of treatment include removing the tumor or reducing tumor burden, normalizing GH secretion and insulin-like growth factor 1 levels, and preserving normal pituitary function if possible. Surgery by an experienced neurosurgeon is still considered first-line therapy, especially in cases with small tumors. In the last few decades, significant progress in the development of selective pharmacologic agents has greatly facilitated the management of active acromegaly, with agents such as somatostatin-receptor ligands (SRLs), GH-receptor antagonists, and dopamine agonists. In addition to adjuvant treatment, pre-operative medical therapy and primary therapy in de novo patients are increasingly employed. A United States National Library of Medicine PubMed search (through July 2014) was conducted for the following terms: acromegaly, pre-operative medical therapy, somatostatin-receptor ligands, and somatostatin analogs. Articles not in English and those not in peer-reviewed journals were excluded. In reviewing pertinent articles, focus was placed on biochemical and other postoperative outcomes of medical therapy. An analysis of the full effect of pre-operative use of SRLs on surgical outcomes (remission rates and peri-operative complications) is limited by heterogeneity of methodology, low overall surgical cure rates, and different study designs. The assumption that SRL use prior to surgery reduces peri-operative surgical risk has yet to be proven. A variable degree of tumor shrinkage with preoperative SRLs is observed. Likewise, SRL treatment 3 months before surgery may improve surgical remission rates in the short term; however, positive results do not persist in the long term. We consider that medical therapy before surgery could play a role in carefully selected patients, but treatment should be individualized. Primary medical therapy with a
AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY COMPREHENSIVE CLINICAL PRACTICE GUIDELINES FOR MEDICAL CARE OF PATIENTS WITH OBESITYEXECUTIVE SUMMARYComplete Guidelines available at https://www.aace.com/publications/guidelines.
Garvey, W Timothy; Mechanick, Jeffrey I; Brett, Elise M; Garber, Alan J; Hurley, Daniel L; Jastreboff, Ania M; Nadolsky, Karl; Pessah-Pollack, Rachel; Plodkowski, Raymond
Development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and the American College of Endocrinology (ACE) Board of Trustees and adheres to published AACE protocols for the standardized production of clinical practice guidelines (CPGs). Recommendations are based on diligent review of clinical evidence with transparent incorporation of subjective factors. There are 9 broad clinical questions with 123 recommendation numbers that include 160 specific statements (85 [53.1%] strong [Grade A], 48 [30.0%] intermediate [Grade B], and 11 [6.9%] weak [Grade C], with 16 [10.0%] based on expert opinion [Grade D]) that build a comprehensive medical care plan for obesity. There were 133 (83.1%) statements based on strong (best evidence level [BEL] 1 = 79 [49.4%]) or intermediate (BEL 2 = 54 [33.7%]) levels of scientific substantiation. There were 34 (23.6%) evidence-based recommendation grades (Grades A-C = 144) that were adjusted based on subjective factors. Among the 1,788 reference citations used in this CPG, 524 (29.3%) were based on strong (evidence level [EL] 1), 605 (33.8%) were based on intermediate (EL 2), and 308 (17.2%) were based on weak (EL 3) scientific studies, with 351 (19.6%) based on reviews and opinions (EL 4). The final recommendations recognize that obesity is a complex, adiposity-based chronic disease, where management targets both weight-related complications and adiposity to improve overall health and quality of life. The detailed evidence-based recommendations allow for nuanced clinical decision-making that addresses real-world medical care of patients with obesity, including screening, diagnosis, evaluation, selection of therapy, treatment goals, and individualization of care. The goal is to facilitate high-quality care of patients with obesity and provide a rational, scientific approach to management that optimizes health outcomes and safety. A1C = hemoglobin A1c AACE = American
Full Text Available Natasha J Williams,1 Girardin Jean-Louis,1 Abhishek Pandey,2 Joseph Ravenell,1 Carla Boutin-Foster,3 Gbenga Ogedegbe1 1Center for Healthful Behavior Change, Division of Internal Medicine, NYU Medical Center, New York, 2Department of Family Medicine, SUNY Downstate Medical Center, Brooklyn, 3Center of Excellence in Disparities Research, Weill Cornell Medical College, New York, NY, USA Background: Excessive daytime sleepiness (EDS often occurs as a result of insufficient sleep, sleep apnea, illicit substance use, and other medical and psychiatric conditions. This study tested the hypothesis that blacks exhibiting EDS would have poorer self-reported adherence to hypertensive medication using cross-sectional data from the Counseling African-Americans to Control Hypertension (CAATCH trial. Methods: A total of 1,058 hypertensive blacks (average age 57±12 years participated in CAATCH, a randomized controlled trial evaluating the effectiveness of a multilevel intervention for participants who receive care from community health centers in New York City. Data analyzed in this study included baseline sociodemographics, medical history, EDS, and medication adherence. We used the Epworth Sleepiness Scale, with a cutoff score of ≥10, to define EDS. Medication adherence was measured using an abbreviated Morisky Medication Adherence scale, with a score >0 indicating nonadherence. Results: Of the sample, 71% were female, 72% received at least a high school education, 51% reported a history of smoking, and 33% had a history of alcohol consumption. Overall, 27% of the participants exhibited EDS, and 44% of those who exhibited EDS were classified as adherent to prescribed antihypertensive medications. Multivariable logistic regression analysis, adjusting for effects of age, body mass index, sex, education, and smoking and drinking history indicated that participants who exhibited EDS were more than twice as likely to be nonadherent (odds ratio 2.28, 95
Remus, Sally; Kennedy, Margaret Ann
In a recent brief to the Canadian Nurses Association's National Expert Commission on the Health of Our Nation, the Academy of Canadian Executive Nurses (ACEN) discussed leadership needs in the Canadian healthcare system, and promoted the pivotal role of nursing executives in transforming Canada's healthcare system into an integrated patient-centric system. Included among several recommendations was the need to develop innovative leadership competencies that enable nurse leaders to lead and advance transformative health system change. This paper focuses on an emerging "avant-garde executive leadership competency" recommended for today's health leaders to guide health system transformation. Specifically, this competency is articulated as "state of the art communication and technology savvy," and it implies linkages between nursing informatics competencies and transformational leadership roles for nurse executive. The authors of this paper propose that distinct nursing informatics competencies are required to augment traditional executive skills to support transformational outcomes of safe, integrated, high-quality care delivery through knowledge-driven care. International trends involving nursing informatics competencies and the evolution of new corporate informatics roles, such as chief nursing informatics officers (CNIOs), are demonstrating value and advanced transformational leadership as nursing executive roles that are informed by clinical data. Copyright © 2013 Longwoods Publishing.
Shiyanbola, Olayinka O; Brown, Carolyn M; Ward, Earlise C
Diabetes is disproportionally burdensome among African-Americans (AAs) and medication adherence is important for optimal outcomes. Limited studies have qualitatively examined reasons for nonadherence among AAs with type 2 diabetes, though AAs are less adherent to prescribed medications compared to whites. This study explored the reasons for medication nonadherence and adherence among AAs with type 2 diabetes and examined AAs' perceived solutions for enhancing adherence. Forty AAs, age 45-60 years with type 2 diabetes for at least 1 year prior, taking at least one prescribed diabetes medication, participated in six semistructured 90-minute focus groups. Using a phenomenology qualitative approach, reasons for nonadherence and adherence, as well as participants' perceived solutions for increasing adherence were explored. Qualitative content analysis was conducted. AAs' reasons for intentional nonadherence were associated with 1) their perception of medicines including concerns about medication side effects, as well as fear and frustration associated with taking medicines; 2) their perception of illness (disbelief of diabetes diagnosis); and 3) access to medicines and information resources. Participants reported taking their medicines because they valued being alive to perform their social and family roles, and their belief in the doctor's recommendation and medication helpfulness. Participants provided solutions for enhancing adherence by focusing on the roles of health care providers, patients, and the church. AAs wanted provider counseling on the necessity of taking medicines and the consequences of not taking them, indicating the need for the AA community to support and teach self-advocacy in diabetes self-management, and the church to act as an advocate in ensuring medication use. Intentional reasons of AAs with type 2 diabetes for not taking their medicines were related to their perception of medicines and illness. Solutions for enhancing diabetes medication
Impact of the New American Heart Association/American Stroke Association Definition of Stroke on the Results of the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis Trial.
Al Kasab, Sami; Lynn, Michael J; Turan, Tanya N; Derdeyn, Colin P; Fiorella, David; Lane, Bethany F; Janis, L Scott; Chimowitz, Marc I
An American Heart Association/American Stroke Association (AHA/ASA) writing committee has recently recommended that tissue evidence of cerebral infarction associated with temporary symptoms (CITS) lasting Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial. We compared outcomes in the medical (n = 227) and stenting (n = 224) groups in SAMMPRIS using the following primary end point (new components in bold): any stroke, CITS, or death within 30 days after enrollment or within 30 days after a revascularization procedure for the qualifying lesion during follow-up; or ischemic stroke or CITS in the territory of the qualifying artery beyond 30 days. We also compared the use of brain magnetic resonance imaging (MRI) after transient ischemic attacks (TIAs) in both treatment groups. By considering CITS as equivalent to stroke, the number of primary end points increased from 34 to 43 in the medical group and from 52 to 66 in the stenting group of SAMMPRIS. The Kaplan-Meier curves for the primary end points in the 2 groups were significantly different (P = .009). The percentage of patients with reported TIAs who underwent brain MRI was 69% in the medical group and 61% in the stenting group (P = .40). Using the AHA/ASA definition of stroke resulted in a substantially higher primary end point rate in both treatment groups and an even higher benefit from medical therapy over stenting than originally shown in SAMMPRIS. The higher rate of CITS in the stenting group was not due to ascertainment bias. Published by Elsevier Inc.
Starting from the physical foundations all mathematics required for the quantum informatics are introduced and explained. The essential aspects of the quantum informatics are mathematically formulated. All statements made are also proved in the book.
The Kazakhstani geopolitical situation raise the concerns on the worsening of the security situation on post-Soviet Central Asia and its involvement into the global informatization demands a development of social informatics as a new educational trend.
Patel, Vimla L; Cohen, Trevor
This interdisciplinary book offers an introduction to cognitive informatics, focusing on key examples drawn from the application of methods and theories from cognitive informatics to challenges specific to the practice of critical-care medicine.
Kampman, Kyle; Jarvis, Margaret
The Centers for Disease Control have recently described opioid use and resultant deaths as an epidemic. At this point in time, treating this disease well with medication requires skill and time that are not generally available to primary care doctors in most practice models. Suboptimal treatment has likely contributed to expansion of the epidemic and concerns for unethical practices. At the same time, access to competent treatment is profoundly restricted because few physicians are willing and able to provide it. This "Practice Guideline" was developed to assist in the evaluation and treatment of opioid use disorder, and in the hope that, using this tool, more physicians will be able to provide effective treatment. Although there are existing guidelines for the treatment of opioid use disorder, none have included all of the medications used at present for its treatment. Moreover, few of the existing guidelines address the needs of special populations such as pregnant women, individuals with co-occurring psychiatric disorders, individuals with pain, adolescents, or individuals involved in the criminal justice system. This Practice Guideline was developed using the RAND Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Method (RAM) - a process that combines scientific evidence and clinical knowledge to determine the appropriateness of a set of clinical procedures. The RAM is a deliberate approach encompassing review of existing guidelines, literature reviews, appropriateness ratings, necessity reviews, and document development. For this project, American Society of Addiction Medicine selected an independent committee to oversee guideline development and to assist in writing. American Society of Addiction Medicine's Quality Improvement Council oversaw the selection process for the independent development committee. Recommendations included in the guideline encompass a broad range of topics, starting with the initial evaluation of the
AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS, AMERICAN COLLEGE OF ENDOCRINOLOGY, AND ASSOCIAZIONE MEDICI ENDOCRINOLOGI MEDICAL GUIDELINES FOR CLINICAL PRACTICE FOR THE DIAGNOSIS AND MANAGEMENT OF THYROID NODULES--2016 UPDATE.
Gharib, Hossein; Papini, Enrico; Garber, Jeffrey R; Duick, Daniel S; Harrell, R Mack; Hegedüs, Laszlo; Paschke, Ralf; Valcavi, Roberto; Vitti, Paolo
malignant or suspicious nodules. The present document updates previous guidelines released in 2006 and 2010 by the American Association of Clinical Endocrinologists (AACE), American College of Endocrinology (ACE) and Associazione Medici Endocrinologi (AME).
Hussein, R; Khalifa, A
During the last decade, Egypt has experienced a revolution in the field of Information and Communication Technology (ICT) that has had a corresponding impact on the field of healthcare. Since 1993, the Information Technology Institute (ITI) has been leading the development of the Information Technology (IT) professional training and education in Egypt to produce top quality IT professionals who are considered now the backbone of the IT revolution in Egypt. For the past five years, ITI has been adopting the objective of building high caliber health professionals who can effectively serve the ever-growing information society. Academic links have been established with internationally renowned universities, e.g., Oregon Health and Science University (OHSU) in US, University of Leipzig in Germany, in addition those with the Egyptian Fellowship Board in order to enrich ITI Medical Informatics Education and Research. The ITI Biomedical and Health Informatics (BMHI) education and training programs target fresh graduates as well as life-long learners. Therefore, the program's learning objectives are framed within the context of the four specialization tracks: Healthcare Management (HCM), Biomedical Informatics Research (BMIR), Bioinformatics Professional (BIP), and Healthcare Professional (HCP). The ITI BMHI research projects tackle a wide-range of current challenges in this field, such as knowledge management in healthcare, providing tele-consultation services for diagnosis and treatment of infectious diseases for underserved regions in Egypt, and exploring the cultural and educational aspects of Nanoinformatics. Since 2006, ITI has been positively contributing to develop the discipline of BMHI in Egypt in order to support improved healthcare services.
Jensen, Camilla Birgitte Falk
to personal informatics systems, and propose an approach to design cognitive interfaces, which considers both users’ motivations, needs, and goals. In this thesis I propose a new personal informatics framework, the feedback loop, which incorporates lean agile design principles. Including hierarchical modeling...... of goals, activities, and tasks to create minimal viable products. While considering how micro-interactions based on an understanding of data, couples with user needs and the context they appear in, can contribute to creating cognitive interfaces. Designing cognitive interfaces requires a focus....... For instance, examining emotional responses to pleasant and unpleasant media content from brain activity, reveals the large amount of data and extensive analysis required to apply this to future personal informatics systems. In addition we analyse challenges related to temporal aspects of the feedback loop...
Sergienko, Ivan V
This work is devoted to the late Ukrainian computer scientist V. M. Glushkov on the 90th anniversary of his birthday. Dr. Glushkov is known for his contribution to the world computer science and technology, and this volume analyzes the ideas and paths of development of informatics formulated by him, and demonstrates their important role in constructing computer technologies of basic research in the fields of applied mathematics, theories of computer programming, and computing systems. A significant portion of the monograph is devoted to the elucidation of new results obtained in the field of mathematical modeling of complicated processes, creation of new methods for solving and investigating optimization problems in different statements, and development of computer technologies for investigations in the field of economy, biology, medicine, and information security in systems. The monograph will be of particular interest to informatics specialists and experts using methods of informatics and computer...
Fiorini, Rodolfo A; De Giacomo, Piero; L'Abate, Luciano
The proper use of healthcare informatics technology and multidimensional conceptual clarity are fundamental to create and boost outstanding clinical and telepractice results. Avoiding even terminology ambiguities is mandatory for high quality of care service. For instance, well-being or wellbeing is a different way to write the same concept only, or there is a good deal of ambiguity around the meanings of these terms the way they are written. In personal health, healthcare and healthcare informatics, this kind of ambiguity and lack of conceptual clarity has been called out repeatedly over the past 50 years. It is time to get the right, terse scenario. We present a brief review to develop and achieve ultimate wellbeing understanding for practical high quality healthcare informatics and telepractice application. This article presents an innovative point of view on deeper wellbeing understanding towards its increased clinical effective application.
Mohapatra, Durga; Chaki, Nabendu
Advanced Computing, Networking and Informatics are three distinct and mutually exclusive disciplines of knowledge with no apparent sharing/overlap among them. However, their convergence is observed in many real world applications, including cyber-security, internet banking, healthcare, sensor networks, cognitive radio, pervasive computing amidst many others. This two volume proceedings explore the combined use of Advanced Computing and Informatics in the next generation wireless networks and security, signal and image processing, ontology and human-computer interfaces (HCI). The two volumes together include 132 scholarly articles, which have been accepted for presentation from over 550 submissions in the Third International Conference on Advanced Computing, Networking and Informatics, 2015, held in Bhubaneswar, India during June 23–25, 2015.
Hua, Ertian; Lin, Yun; Liu, Xiaozhu
Computer Informatics Cybernetics and Applications offers 91 papers chosen for publication from among 184 papers accepted for presentation to the International Conference on Computer, Informatics, Cybernetics and Applications 2011 (CICA 2011), held in Hangzhou, China, September 13-16, 2011. The CICA 2011 conference provided a forum for engineers and scientists in academia, industry, and government to address the most innovative research and development including technical challenges and social, legal, political, and economic issues, and to present and discuss their ideas, results, work in progress and experience on all aspects of Computer, Informatics, Cybernetics and Applications. Reflecting the broad scope of the conference, the contents are organized in these topical categories: Communication Technologies and Applications Intelligence and Biometrics Technologies Networks Systems and Web Technologies Data Modeling and Programming Languages Digital Image Processing Optimization and Scheduling Education and In...
Full Text Available The perspective from which information processing is pervasive in the universe has proven to be an increasingly productive one. Phenomena from the quantum level to social networks have commonalities that can be usefully explicated using principles of informatics. We argue that the notion of scale is particularly salient here. An appreciation of what is invariant and what is emergent across scales, and of the variety of different types of scales, establishes a useful foundation for the transdiscipline of informatics. We survey the notion of scale and use it to explore the characteristic features of information statics (data, kinematics (communication, and dynamics (processing. We then explore the analogy to the principles of plenitude and continuity that feature in Western thought, under the name of the "great chain of being", from Plato through Leibniz and beyond, and show that the pancomputational turn is a modern counterpart of this ruling idea. We conclude by arguing that this broader perspective can enhance informatics pedagogy.
Hills, Rebecca A; Turner, Anne M
State and local health departments are witnessing growth in the area of informatics. As new informatics projects commence, existing methods of communication within the health department may not be sufficient. We gathered information about roles and communication between a development team and a user group working simultaneously on an informatics project in a state public health department in an effort to better define how communication and role definition is best used within an informatics project.
Kassam, Iman; Nagle, Lynn; Strudwick, Gillian
Globally, health information technologies are now being used by nurses in a variety of settings. However, nurse leaders often do not have the necessary strategic and tactical informatics competencies to adequately ensure their effective adoption and use. Although informatics competencies and competency frameworks have been identified and developed, to date there has not been review or consolidation of the work completed in this area. In order to address this gap, a scoping review is being conducted. The objectives of this scoping review are to: (1) identify informatics competencies of relevance to nurse leaders, (2) identify frameworks or theories that have been used to develop informatics competencies for nurse leaders, (3) identify instruments used to assess the informatics competencies of nurse leaders and (4) examine the psychometric properties of identified instruments. Using the Arksey and O'Malley five-step framework, a literature review will be conducted using a scoping review methodology. The search will encompass academic and grey literature and include two primary databases and five secondary databases. Identified studies and documents will be independently screened for eligibility by two reviewers. Data from the studies and documents will be extracted and compiled into a chart. Qualitative data will be subject to a thematic analysis and descriptive statistics applied to the quantitative data. Ethical approval was not required for this study. Results will be used to inform a future study designed to validate an instrument used to evaluate informatics competencies for nurse leaders within a Canadian context. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Nesbitt, Gerry; McKenna, Kevin; Mays, Vickie; Carpenter, Alan; Miller, Kevin; Williams, Michael
The Epilepsy Phenome/Genome Project (EPGP) is a large-scale, multi-institutional, collaborative network of 27 epilepsy centers throughout the U.S., Australia, and Argentina, with the objective of collecting detailed phenotypic and genetic data on a large number of epilepsy participants. The goals of EPGP are (1) to perform detailed phenotyping on 3750 participants with specific forms of non-acquired epilepsy and 1500 parents without epilepsy, (2) to obtain DNA samples on these individuals, and (3) to ultimately genotype the samples in order to discover novel genes that cause epilepsy. To carry out the project, a reliable and robust informatics platform was needed for standardized electronic data collection and storage, data quality review, and phenotypic analysis involving cases from multiple sites. EPGP developed its own suite of web-based informatics applications for participant tracking, electronic data collection (using electronic case report forms/surveys), data management, phenotypic data review and validation, specimen tracking, electroencephalograph and neuroimaging storage, and issue tracking. We implemented procedures to train and support end-users at each clinical site. Thus far, 3780 study participants have been enrolled and 20,957 web-based study activities have been completed using this informatics platform. Over 95% of respondents to an end-user satisfaction survey felt that the informatics platform was successful almost always or most of the time. The EPGP informatics platform has successfully and effectively allowed study management and efficient and reliable collection of phenotypic data. Our novel informatics platform met the requirements of a large, multicenter research project. The platform has had a high level of end-user acceptance by principal investigators and study coordinators, and can serve as a model for new tools to support future large scale, collaborative research projects collecting extensive phenotypic data. Copyright © 2012
Brink, James A; Arenson, Ronald L; Grist, Thomas M; Lewin, Jonathan S; Enzmann, Dieter
Advances in informatics and information technology are sure to alter the practice of medical imaging and image-guided therapies substantially over the next decade. Each element of the imaging continuum will be affected by substantial increases in computing capacity coincident with the seamless integration of digital technology into our society at large. This article focuses primarily on areas where this IT transformation is likely to have a profound effect on the practice of radiology. • Clinical decision support ensures consistent and appropriate resource utilization. • Big data enables correlation of health information across multiple domains. • Data mining advances the quality of medical decision-making. • Business analytics allow radiologists to maximize the benefits of imaging resources.
The paper describes nowadays information technology skills in the Czech Republic. It focuses on informatics education using Internet, ECDL concept and the links between computer literacy among health care professionals and quality of health care. Everyone understands that the main source of wealth of any nation is information management and the efficient transformation of information into knowledge. There appear completely new decisive factors for the economics of the near future based on circulation and exchange information. It is clear that modern health care cannot be built without information and communication technologies. We discuss several approaches how to contribute to some topics of information society in health care, namely the role of electronic health record, structured information, extraction of information from free medical texts and sharing knowledge stored in medical guidelines.
David S McClintock
Full Text Available Background: In 2007, our healthcare system established a clinical fellowship program in Pathology Informatics. In 2010 a core didactic course was implemented to supplement the fellowship research and operational rotations. In 2011, the course was enhanced by a formal, structured core curriculum and reading list. We present and discuss our rationale and development process for the Core Curriculum and the role it plays in our Pathology Informatics Fellowship Training Program. Materials and Methods: The Core Curriculum for Pathology Informatics was developed, and is maintained, through the combined efforts of our Pathology Informatics Fellows and Faculty. The curriculum was created with a three-tiered structure, consisting of divisions, topics, and subtopics. Primary (required and suggested readings were selected for each subtopic in the curriculum and incorporated into a curated reading list, which is reviewed and maintained on a regular basis. Results: Our Core Curriculum is composed of four major divisions, 22 topics, and 92 subtopics that cover the wide breadth of Pathology Informatics. The four major divisions include: (1 Information Fundamentals, (2 Information Systems, (3 Workflow and Process, and (4 Governance and Management. A detailed, comprehensive reading list for the curriculum is presented in the Appendix to the manuscript and contains 570 total readings (current as of March 2012. Discussion: The adoption of a formal, core curriculum in a Pathology Informatics fellowship has significant impacts on both fellowship training and the general field of Pathology Informatics itself. For a fellowship, a core curriculum defines a basic, common scope of knowledge that the fellowship expects all of its graduates will know, while at the same time enhancing and broadening the traditional fellowship experience of research and operational rotations. For the field of Pathology Informatics itself, a core curriculum defines to the outside world
Betts, Helen J; Wright, Graham
As nurses around the world prepare to celebrate the centenary of the death of Florence Nightingale in 2010 this paper reviews her work on using information, especially statistics, to analyze and manage patient care and links that to current developments in informatics. It then examines assistive technologies and how they may impact on nursing practice in the future and links these developments to the writings of Florence Nightingale. The paper concludes by suggesting that in progressing towards sustainable and ubiquitous healthcare informatics we need to study history in order to learn from the lessons of Florence Nightingale and other healthcare pioneers.
Eduardo Hernández Martín
Full Text Available To achieve a differentiated teaching learning process in informatics, in which each student should be able to keep his/her own rhythm, is one of the most complex themes to deal with at any educational level. The present work is the result of the scientific methodological work in the Educative Informatics discipline, it is pretended to reflect about the way of using the UCP LAN in the teaching learning process. To carry out the article some documents such as the disciplines and subjects study syllabuses were revised, the information obtained from an updated bibliography was analyzed – synthesized and itwas exemplified with a theory practical lesson.
2017 American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty.
Goodman, Susan M; Springer, Bryan; Guyatt, Gordon; Abdel, Matthew P; Dasa, Vinod; George, Michael; Gewurz-Singer, Ora; Giles, Jon T; Johnson, Beverly; Lee, Steve; Mandl, Lisa A; Mont, Michael A; Sculco, Peter; Sporer, Scott; Stryker, Louis; Turgunbaev, Marat; Brause, Barry; Chen, Antonia F; Gililland, Jeremy; Goodman, Mark; Hurley-Rosenblatt, Arlene; Kirou, Kyriakos; Losina, Elena; MacKenzie, Ronald; Michaud, Kaleb; Mikuls, Ted; Russell, Linda; Sah, Alexander; Miller, Amy S; Singh, Jasvinder A; Yates, Adolph
This collaboration between the American College of Rheumatology and the American Association of Hip and Knee Surgeons developed an evidence-based guideline for the perioperative management of antirheumatic drug therapy for adults with rheumatoid arthritis (RA), spondyloarthritis (SpA) including ankylosing spondylitis and psoriatic arthritis, juvenile idiopathic arthritis (JIA), or systemic lupus erythematosus (SLE) undergoing elective total hip (THA) or total knee arthroplasty (TKA). A panel of rheumatologists, orthopedic surgeons specializing in hip and knee arthroplasty, and methodologists was convened to construct the key clinical questions to be answered in the guideline. A multi-step systematic literature review was then conducted, from which evidence was synthesized for continuing versus withholding antirheumatic drug therapy and for optimal glucocorticoid management in the perioperative period. A Patient Panel was convened to determine patient values and preferences, and the Grading of Recommendations Assessment, Development and Evaluation methodology was used to rate the quality of evidence and the strength of recommendations, using a group consensus process through a convened Voting Panel of rheumatologists and orthopedic surgeons. The strength of the recommendation reflects the degree of certainty that benefits outweigh harms of the intervention, or vice versa, considering the quality of available evidence and the variability in patient values and preferences. The guideline addresses the perioperative use of antirheumatic drug therapy including traditional disease-modifying antirheumatic drugs, biologic agents, tofacitinib, and glucocorticoids in adults with RA, SpA, JIA, or SLE who are undergoing elective THA or TKA. It provides recommendations regarding when to continue, when to withhold, and when to restart these medications, and the optimal perioperative dosing of glucocorticoids. The guideline includes 7 recommendations, all of which are conditional
Full Text Available Introduction: Hospital information system (HIS is a computerized system used for management of hospital information as an electronic device and has an indispensible role in the field of qualified healthcare services. Nevertheless, compared to other industrial and commercial systems, this information system is lagged in using the information technology and applying the controlling standards for satisfying the customers. Therefore, the present study aimed to evaluate HIS, identify its strength and weak points, and improve it in the teaching hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. Method: The present descriptive, cross-sectional study was conducted in the 8 teaching hospitals of Shiraz University of Medical Sciences which used HIS in 2011. The study data were collected through interview and direct observation using the criteria of American Physician College check-list. Finally, SPSS statistical software was used to analyze the data through descriptive statistics. Results: The study results showed that laboratory and medical records had respectively the most %43.5 and the least %21.03 conformity to the criteria of American College of Physicians. Also, Faghihi and Zeinabiye hospitals respectively had the most %41.8 and the least %25.2 conformity to the American College of Physicians’ criteria. In pharmacy, data entrance mechanism and presentation of reports had complete conformity to the scales of American College of Physicians, while drug interactions showed no conformity. In laboratory, data entrance mechanism had complete conformity to the above-mentioned criteria and keeping the test history had %87.5 conformity. The possibility of receiving information from centers out of laboratory had no conformity to the desired criteria. In the radiology department, data entrance mechanism had complete conformity to the above-mentioned criteria and keeping the test history had %87.5 conformity. Besides, the possibility
Nitschke, J E; Nattrass, C L; Disler, P B; Chou, M J; Ooi, K T
Repeated measures design for intra- and interrater reliability. To determine the intra- and interrater reliability of the lumbar spine range of motion measured with a dual inclinometer, and the thoracolumbar spine range of motion measured with a long-arm goniometer, as recommended in the American Medical Association Guides. The American Medical Association Guides (2nd and 4th editions) recommend using measurements of thoracolumbar and lumbar range of movement, respectively, to estimate the percentage of permanent impairment in patients with chronic low back pain. However, the reliability of this method of estimating impairment has not been determined. In all, 34 subjects participated in the study, 21 women with a mean age of 40.1 years (SD, +/- 11.1) and 13 men with a mean age of 47.7 years (SD, +/- 12.1). Measures of thoracolumbar flexion, extension, lateral flexion, and rotation were obtained with a long-arm goniometer. Lumbar flexion, extension, and lateral flexion were measured with a dual inclinometer. Measurements were taken by two examiners on one occasion and by one examiner on two occasions approximately 1 week apart. The results showed poor intra- and interrater reliability for all measurements taken with both instruments. Measurement error expressed in degrees showed that measurements taken by different raters exhibited systematic as well as random differences. As a result, subjects measured by two different examiners on the same day, with either instrument, could give impairment ratings ranging between 0% and 18% of the whole person (excluding rotation), in which percentage impairment is calculated using the average range of motion and the average systematic and random error in degrees for the group for each movement (flexion, extension, and lateral flexion). The poor reliability of the American Medical Association Guides' spinal range of motion model can result in marked variation in the percentage of whole-body impairment. These findings have
Consumer health informatics (CHI) is propelling important changes for medical providers and the lives of patients through information and communications technology. Independently, medical consumers seek, collect, and use health information for decision making. However, when constructing a CHI-based medical platform, high technology must be applied in a fully understandable and usable format for both health care providers and consumers. This study examines the present status of CHI and its effect on medical consumers. For the development of CHI, we discuss the need for tailored health communications and capacity building with chronic patients at the medical center. First, empowerment is a key characteristic needed for medical consumer health care management. However, promoting patient self-care management of illnesses and health is necessary to create conjugation where cooperation with medical service providers is possible. Also, establishing a health care delivery system that will support cooperation is necessary. Second, tailored health communications can uniquely construct the health information of patients, which prevents unnecessary or excessive information from leading patients to confused and inappropriate decisions. Ultimately, through the present environment of health communication, the innovation of a consumer health care information system has become the tide of the times and the positive effect of improved health can be expected.
Figueroa, Caroline A; Rassam, Fadi; Spong, Karin S
In April 2012, 20 medical students took part in a study tour to San Francisco, themed 'ethnic diversity in health care'. In this article we discuss four lessons learned from the perspective of these students. The delivery of culturally sensitive healthcare is becoming more important in the Netherlands as the ethnic minority population rate will continue to grow over the coming years. However, diversity education is not a structural component of medical curricula in the Netherlands to the same degree as in the USA where medical education pays a lot of attention to differences in health between ethnic minorities; and where there is also extensive research on this subject. We emphasize that diversity education should create awareness of differences in health outcomes between ethnic groups and awareness of one's own bias and stereotypical views. The implementation of diversity education is a challenge, which requires a change of image and the involvement of teachers from diverse medical disciplines.
Kong, Chang Sun
This thesis addresses one of the fundamental questions in materials crystal chemistry, namely why do atoms arrange themselves in the way they do? The ability to broadly design and predict new phases [i.e. crystal structures] can be partly met using concepts that employ phase homologies. Homologous series of compounds are those that seem chemically diverse but can be expressed in terms of a mathematical formula that is capable of producing each chemical member in that crystal structure. A well-established strategy to help discover new compounds -- or at least to try to develop chemical design strategies for discovery -- is to search, organize and classify homologous compounds from known data. These classification schemes are developed with the hope that they can provide sufficient insight to help us forecast with some certainty, specific new phases or compounds. Yet, while the classification schemes (over a dozen have been reported in the last 50 years) have proved to be instructive, mostly in hindsight, but they have had limited impact, if at all, on the a priori design of materials chemistry. The aim of this research project is to develop a totally new approach to the study of chemical complexity in materials science using the tools of information theory and data science, which link diverse and high dimensional data derived from physical modeling and experiments. A very large scale binary AB2 crystallographic database is used as a data platform to develop a new data mining/informatics protocol based on high dimensional recursive partitioning schemes coupled to information theoretic measures to: (1) Identify which type of structure prototype is preferred over another for a given chemistry of compound; (2) discover new classification schemes of structure/chemistry/property relationships that classical homologies do not detect and finally we; (3) Extract and organize the underlying design rules for the formation of a given structure by quantitatively assessing the
Finkelstein, Joseph; Barr, Michael S; Kothari, Pranav P; Nace, David K; Quinn, Matthew
The patient-centered medical home (PCMH) is an approach that evolved from the understanding that a well-organized, proactive clinical team working in a tandem with well-informed patients is better able to address the preventive and disease management needs in a guideline-concordant manner. This approach represents a fundamental shift from episodic acute care models and has become an integral part of health reform supported on a federal level. The major aspects of PCMH, especially pertinent to its information infrastructure, have been discussed by an expert panel organized by the Agency for Healthcare Research and Quality at the Informatics for Consumer Health Summit. The goal of this article is to summarize the panel discussions along the four major domains presented at the summit: (1) PCMH as an Evolving Model of Healthcare Delivery; (2) Health Information Technology (HIT) Applications to Support the PCMH; (3) Current HIT Landscape of PCMH: Challenges and Opportunities; and (4) Future HIT Landscape of PCMH: Federal Initiatives on Health Informatics, Legislation, and Standardization. Copyright © 2011 American Journal of Preventive Medicine. All rights reserved.
Koppel, Barbara S; Brust, John C M; Fife, Terry; Bronstein, Jeff; Youssof, Sarah; Gronseth, Gary; Gloss, David
To determine the efficacy of medical marijuana in several neurologic conditions. We performed a systematic review of medical marijuana (1948-November 2013) to address treatment of symptoms of multiple sclerosis (MS), epilepsy, and movement disorders. We graded the studies according to the American Academy of Neurology classification scheme for therapeutic articles. Thirty-four studies met inclusion criteria; 8 were rated as Class I. The following were studied in patients with MS: (1) Spasticity: oral cannabis extract (OCE) is effective, and nabiximols and tetrahydrocannabinol (THC) are probably effective, for reducing patient-centered measures; it is possible both OCE and THC are effective for reducing both patient-centered and objective measures at 1 year. (2) Central pain or painful spasms (including spasticity-related pain, excluding neuropathic pain): OCE is effective; THC and nabiximols are probably effective. (3) Urinary dysfunction: nabiximols is probably effective for reducing bladder voids/day; THC and OCE are probably ineffective for reducing bladder complaints. (4) Tremor: THC and OCE are probably ineffective; nabiximols is possibly ineffective. (5) Other neurologic conditions: OCE is probably ineffective for treating levodopa-induced dyskinesias in patients with Parkinson disease. Oral cannabinoids are of unknown efficacy in non-chorea-related symptoms of Huntington disease, Tourette syndrome, cervical dystonia, and epilepsy. The risks and benefits of medical marijuana should be weighed carefully. Risk of serious adverse psychopathologic effects was nearly 1%. Comparative effectiveness of medical marijuana vs other therapies is unknown for these indications.
... and Asian American Women Osteoporosis and Asian American Women Asian American women are at high risk for ... medications. Are There Any Special Issues for Asian Women Regarding Bone Health? Recent studies indicate a number ...
In Young Choi
Full Text Available The advances in electronic medical records (EMRs and bioinformatics (BI represent two significant trends in healthcare. The widespread adoption of EMR systems and the completion of the Human Genome Project developed the technologies for data acquisition, analysis, and visualization in two different domains. The massive amount of data from both clinical and biology domains is expected to provide personalized, preventive, and predictive healthcare services in the near future. The integrated use of EMR and BI data needs to consider four key informatics areas: data modeling, analytics, standardization, and privacy. Bioclinical data warehouses integrating heterogeneous patient-related clinical or omics data should be considered. The representative standardization effort by the Clinical Bioinformatics Ontology (CBO aims to provide uniquely identified concepts to include molecular pathology terminologies. Since individual genome data are easily used to predict current and future health status, different safeguards to ensure confidentiality should be considered. In this paper, we focused on the informatics aspects of integrating the EMR community and BI community by identifying opportunities, challenges, and approaches to provide the best possible care service for our patients and the population.
Staccini, P; Douali, N
To provide a review of the current excellent research published in the field of Consumer Health Informatics. We searched MEDLINE® and WEB OF SCIENCE® databases for papers published in 2013 in relation with Consumer Health Informatics. The authors identified 16 candidate best papers, which were then reviewed by four reviewers. Five out of the 16 candidate papers were selected as best papers. One paper presents the key features of a system to automate the collection of web-based social media content for subsequent semantic annotation. This paper emphasizes the importance of mining social media to collect novel data from which new findings in drug abuse research were uncovered. The second paper presents a practical method to predict how a community structure would impact the spreading of information within the community. The third paper presents a method for improving the quality of online health communities. The fourth presents a new social network to allow the monitoring of the evolution of individuals' health status and diagnostic deficiencies, difficulties or barriers in rehabilitation. The last paper reports on teenage patients' perception on privacy and social media. Selected papers not only show the value of using social media in the medical field but how to use these media to detect emergent diseases or risks, inform patients, promote disease prevention, and follow patients' opinion on healthcare resources.
This standard provides guidance for first aid during an emergency and for initial medical care of those persons on-site who are overexposed to penetrating radiation (irradiated). It also provides guidance for medical care of persons contaminated with radioactive material or radionuclides who may also be irradiated or injured as a result of an accident at a nuclear power plant. It provides recommendations for facilities, supplies, equipment, and the extent of care both on-site where first aid and initial care may be provided and off-site at a local hospital where further medical and surgical care may be provided. This initial care continues until either the patient is released or admitted, or referred to another, possibly distant, medical center for definitive care. Recommendations are also provided for the transportation of patients and the training of personnel. Recommendations for specialized care are considered to be beyond the scope of this standard on emergency medical care; however, since emergency and specialized care are related, a brief discussion of specialized care is provided in the Appendix
Glass, Charity C; Acton, Robert D; Blair, Patrice G; Campbell, Andre R; Deutsch, Ellen S; Jones, Daniel B; Liscum, Kathleen R; Sachdeva, Ajit K; Scott, Daniel J; Yang, Stephen C
Simulation can enhance learning effectiveness, efficiency, and patient safety and is engaging for learners. A survey was conducted of surgical clerkship directors nationally and medical students at 5 medical schools to rank and stratify simulation-based educational topics. Students applying to surgery were compared with others using Wilcoxon's rank-sum tests. Seventy-three of 163 clerkship directors (45%) and 231 of 872 students (26.5%) completed the survey. Of students, 28.6% were applying for surgical residency training. Clerkship directors and students generally agreed on the importance and timing of specific educational topics. Clerkship directors tended to rank basic skills, such as examination skills, higher than medical students. Students ranked procedural skills, such as lumbar puncture, more highly than clerkship directors. Surgery clerkship directors and 4th-year medical students agree substantially about the content of a simulation-based curriculum, although 4th-year medical students recommended that some topics be taught earlier than the clerkship directors recommended. Students planning to apply to surgical residencies did not differ significantly in their scoring from students pursuing nonsurgical specialties. Copyright © 2014 Elsevier Inc. All rights reserved.
Vaccaro Joan A
Full Text Available Abstract Background Diabetes has reached epidemic proportions in the United States, particularly among minorities, and if improperly managed can lead to medical complications and death. Healthcare providers play vital roles in communicating standards of care, which include guidance on diabetes self-management. The background of the client may play a role in the patient-provider communication process. The aim of this study was to determine the association between medical advice and diabetes self care management behaviors for a nationally representative sample of adults with diabetes. Moreover, we sought to establish whether or not race/ethnicity was a modifier for reported medical advice received and diabetes self-management behaviors. Methods We analyzed data from 654 adults aged 21 years and over with diagnosed diabetes [130 Mexican-Americans; 224 Black non-Hispanics; and, 300 White non-Hispanics] and an additional 161 with 'undiagnosed diabetes' [N = 815(171 MA, 281 BNH and 364 WNH] who participated in the National Health and Nutrition Examination Survey (NHANES 2007-2008. Logistic regression models were used to evaluate whether medical advice to engage in particular self-management behaviors (reduce fat or calories, increase physical activity or exercise, and control or lose weight predicted actually engaging in the particular behavior and whether the impact of medical advice on engaging in the behavior differed by race/ethnicity. Additional analyses examined whether these relationships were maintained when other factors potentially related to engaging in diabetes self management such as participants' diabetes education, sociodemographics and physical characteristics were controlled. Sample weights were used to account for the complex sample design. Results Although medical advice to the patient is considered a standard of care for diabetes, approximately one-third of the sample reported not receiving dietary, weight management, or physical
Sittig, Dean F.; Hazlehurst, Brian L.; Brown, Jeffrey; Murphy, Shawn; Rosenman, Marc; Tarczy-Hornoch, Peter; Wilcox, Adam B.
Comparative Effectiveness Research (CER) has the potential to transform the current healthcare delivery system by identifying the most effective medical and surgical treatments, diagnostic tests, disease prevention methods and ways to deliver care for specific clinical conditions. To be successful, such research requires the identification, capture, aggregation, integration, and analysis of disparate data sources held by different institutions with diverse representations of the relevant clinical events. In an effort to address these diverse demands, there have been multiple new designs and implementations of informatics platforms that provide access to electronic clinical data and the governance infrastructure required for inter-institutional CER. The goal of this manuscript is to help investigators understand why these informatics platforms are required and to compare and contrast six, large-scale, recently funded, CER-focused informatics platform development efforts. We utilized an 8-dimension, socio-technical model of health information technology use to help guide our work. We identified six generic steps that are necessary in any distributed, multi-institutional CER project: data identification, extraction, modeling, aggregation, analysis, and dissemination. We expect that over the next several years these projects will provide answers to many important, and heretofore unanswerable, clinical research questions. PMID:22692259
Sittig, Dean F; Hazlehurst, Brian L; Brown, Jeffrey; Murphy, Shawn; Rosenman, Marc; Tarczy-Hornoch, Peter; Wilcox, Adam B
Comparative effectiveness research (CER) has the potential to transform the current health care delivery system by identifying the most effective medical and surgical treatments, diagnostic tests, disease prevention methods, and ways to deliver care for specific clinical conditions. To be successful, such research requires the identification, capture, aggregation, integration, and analysis of disparate data sources held by different institutions with diverse representations of the relevant clinical events. In an effort to address these diverse demands, there have been multiple new designs and implementations of informatics platforms that provide access to electronic clinical data and the governance infrastructure required for interinstitutional CER. The goal of this manuscript is to help investigators understand why these informatics platforms are required and to compare and contrast 6 large-scale, recently funded, CER-focused informatics platform development efforts. We utilized an 8-dimension, sociotechnical model of health information technology to help guide our work. We identified 6 generic steps that are necessary in any distributed, multi-institutional CER project: data identification, extraction, modeling, aggregation, analysis, and dissemination. We expect that over the next several years these projects will provide answers to many important, and heretofore unanswerable, clinical research questions.
Li, Ian; Medynskiy, Yevgeniy; Froehlich, Jon
of personal informatics applications poses new challenges for human-computer interaction and creates opportunities for applications in various domains related to quality of life, such as fitness, nutrition, wellness, mental health, and sustainability. This workshop will continue the conversations from the CHI...
Over the past decade, there has been a conversion to electronic health records (EHRs) in an effort to improve patient care, access, and efficiency. The goal, which has been supported by federal initiatives, is to meaningfully use informatics to improve the safety and quality of patient care as a major force in improving healthcare. How nurses…
Lawler, James; Joseph, Anthony; Narula, Stuti
Corporate entrepreneurship is a critical area of curricula for computer science and information systems students. Few institutions of computer science and information systems have entrepreneurship in the curricula however. This paper presents entrepreneurial health informatics as a course in a concentration of Technology Entrepreneurship at a…
Because of the widespread use of microcomputers in Bulgaria, informatics education for all college students is considered both possible and necessary. Uses of microcomputers in various disciplines are described, including those in mathematics/mechanics, the experimental sciences, and humanities. Brief comments on computer-assisted-learning and…
Zvárová, Jana; Hanzlíček, Petr; Nagy, Miroslav; Přečková, Petra; Zvára, K.; Seidl, L.; Bureš, V.; Šubrt, D.; Dostálová, T.; Seydlová, M.
Roč. 29, č. 2 (2009), s. 31-41 ISSN 0208-5216 R&D Projects: GA AV ČR 1ET200300413 Institutional research plan: CEZ:AV0Z10300504 Keywords : electronic health record * semantic interoperability * dentistry * cardiology Subject RIV: IN - Informatics, Computer Science
Kriseman, Jeffrey Michael
This work involved the analysis of a public health system, and the design, development and deployment of enterprise informatics architecture, and sustainable community methods to address problems with the current public health system. Specifically, assessment of the Nationally Notifiable Disease Surveillance System (NNDSS) was instrumental in…
Kantser, V.; Andronic, S.
This book includes articles which cover a vast range of subjects, such as: telecommunications networks and technologies; electronic, optoelectronic, photonic and information systems and devices; materials, components and equipment in electronics and communications; informatics and computer science; software development and testing etc.
Tatkovic, Nevenka; Ruzic, Maja; Pecaric, Dilda
The life and activities of every man in the period of transition from the second into the third millennium have been marked by epochal changes which appear as the consequence of scientific and technological revolution dominated by highly developed information and communication technology. Informatics and information education based on information…
Bethell, Christina D; Read, Debra; Brockwood, Krista
National health goals include ensuring that all children have a medical home. Historically, medical home has been determined by the presence of a usual or primary source of care, such as a pediatrician or a family physician. More recent definitions expand on this simplistic notion of medical home. A definition of medical home set forth by the American Academy of Pediatrics (AAP) includes 7 dimensions and 37 discrete concepts for determining the presence of a medical home for a child. Standardized methods to operationalize these definitions for purposes of national, state, health plan, or medical practice level reporting on the presence of medical homes for children are essential to assessing and improving health care system performance in this area. The objective of this study was to identify methods to measure the presence of medical homes for all children and for children with special health care needs (CSHCN) using existing population-based data sets. Methods were developed for using existing population-based data sets to assess the presence of medical homes, as defined by the AAP, for children with and without special health care needs. Data sets evaluated included the National Survey of Children With Special Health Care Needs, the National Medical Expenditures Panel Survey, the Consumer Assessment of Health Plans Study Child Survey (CAHPS), and the Consumer Assessment of Health Plans Study Child Survey--Children With Chronic Conditions (CAHPS-CCC2.0H). Alternative methods for constructing measures using existing data were compared and results used to inform the design of a new method for use in the upcoming National Survey of Children's Health. Data from CAHPS-CCC2.0H are used to illustrate measurement options and variations in the overall presence of medical homes for children across managed health care plans as well as to evaluate in which areas of the AAP definition of medical home improvements may be most needed for all CSHCN. Existing surveys vary in
Bustamante, Arturo Vargas
Neil Lunt and Russel Mannion provide an overview of the current state of the medical tourism literature and propose areas for future research in health policy and management. The authors also identify the main unanswered questions in this field ranging from the real size of the medical tourism market to the particular health profiles of transnational patients. In addition, they highlight unexplored areas of research from health economics, ethics, policy and management perspectives. To this very insightful editorial I would add the international trade perspective. While globalization has permeated labor and capital, services such as healthcare are still highly regulated by governments, constrained to regional or national borders and protected by organized interests. Heterogeneity of healthcare regulations and lack of cross-country reciprocity agreements act as barriers to the development of more widespread and dynamic medical tourism markets. To picture these barriers to transnational health services I use evidence from North America, identifying different "pull and push factors" for medical tourist in this region, discussing how economic integration and healthcare reform might shift the incentives to utilize healthcare abroad.
Biomedical and health informatics (BHI) is a rapidly growing domain that relies on the active collaboration with diverse disciplines and professions. Educational initiatives in BHI need to prepare students with skills and competencies that will allow them to function within and even facilitate interdisciplinary teams (IDT). This paper describes an interdisciplinary educational approach introduced into a BHI graduate curriculum that aims to prepare informatics researchers to lead IDT research. A case study of the "gerontechnology" research track is presented which highlights how the curriculum fosters collaboration with and understanding of the disciplines of Nursing, Engineering, Computer Science, and Health Administration. Gerontechnology is a new interdisciplinary field that focuses on the use of technology to support aging. Its aim is to explore innovative ways to use information technology and develop systems that support independency and increase quality of life for senior citizens. As a result of a large research group that explores "smart home" technologies and the use of information technology, we integrated this new domain into the curriculum providing a platform for computer scientists, engineers, nurses and physicians to explore challenges and opportunities with our informatics students and faculty. The interdisciplinary educational model provides an opportunity for health informatics students to acquire the skills for communication and collaboration with other disciplines. Numerous graduate and postgraduate students have already participated in this initiative. The evaluation model of this approach is presented. Interdisciplinary educational models are required for health informatics graduate education. Such models need to be innovative and reflect the needs and trends in the domains of health care and information technology.
Hsi, Andy C; Kreisel, Friederike H; Frater, John L; Nguyen, TuDung T
Human T-cell lymphotropic virus type 1 is associated with adult T-cell leukemia/lymphoma (ATLL). Published series of ATLLs seen at a United States medical institution are rare. We present the features of 4 ATLLs diagnosed at our North American tertiary care medical center from 1990 to 2012. Despite the absence of a history of origin from an endemic region, all our ATLLs demonstrated evidence of human T-cell lymphotropic virus type 1 infection. Central nervous system (CNS) involvement by ATLL was uncommon in our series, and represented only 1.6% (1/64) of all CNS B-cell or T-cell lymphomas diagnosed over a 20+ year period at our institution. Review of the medical literature reveals that the majority of CNS-involved ATLLs present with the lymphoma or acute subtype, and complete remission is difficult to achieve in these cases. CNS involvement frequently occurs with a systemic disease, which carries an aggressive clinical course with poor prognosis. In addition, CNS involvement by ATLL can be the initial presentation or seen with relapsed disease, can be the only site or be associated with other tissue sites of involvement, and may manifest with variable clinical signs/symptoms. Our retrospective study reveals that ATLLs are rare mature T-cell lymphomas in a native North American population, but the clinical and histopathologic features of ATLLs from this nonendemic region are similar to those seen from other endemic regions. Early recognition of these rare ATLLs involving uncommon sites, such as the CNS, will help optimize treatment for these infrequent mature T-cell lymphomas.
Gabriel, Meghan Hufstader; Smith, Jaime Y; Sow, Max; Charles, Dustin; Joseph, Seth; Wilkins, Tricia Lee
To document national trends of electronic medication history use in the ambulatory setting and describe the characteristics and predicting factors of providers who regularly use medication history transaction capabilities through their e-prescribing systems. The study used provider-initiated medication history data requests, electronically sent over an e-prescribing network from all 50 states and the District of Columbia. Data from 138,000 prescribers were evaluated using multivariate analyses from 2007 to 2013. Medication history use showed significant growth, increasing from 8 to 850 million history requests during the study period. Prescribers on the network for histories more often than those in large and small cities, these findings were not significant in multivariate analyses. Providers in orthopedic surgery and internal medicine had a higher likelihood of more requests than family practice prescribers, with 12% and 7% higher likelihood, respectively. Early adopters of e-prescribing have remained medication history users and have continually increased their volume of requests for medication histories. Despite the fact that the use of medication histories through e-prescribing networks in the ambulatory care setting has not been encouraged through federal incentive programs, there has been substantial growth in the use of medication histories offered through e-prescribing networks. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: email@example.com.
Roy E Lee
Full Text Available Background: Last year, our pathology informatics fellowship added informatics-based interactive case studies to its existing educational platform of operational and research rotations, clinical conferences, a common core curriculum with an accompanying didactic course, and national meetings. Methods: The structure of the informatics case studies was based on the traditional business school case study format. Three different formats were used, varying in length from short, 15-minute scenarios to more formal multiple hour-long case studies. Case studies were presented over the course of three retreats (Fall 2011, Winter 2012, and Spring 2012 and involved both local and visiting faculty and fellows. Results: Both faculty and fellows found the case studies and the retreats educational, valuable, and enjoyable. From this positive feedback, we plan to incorporate the retreats in future academic years as an educational component of our fellowship program. Conclusions: Interactive case studies appear to be valuable in teaching several aspects of pathology informatics that are difficult to teach in more traditional venues (rotations and didactic class sessions. Case studies have become an important component of our fellowship′s educational platform.
Andrew J King
Full Text Available The University of Pittsburgh's Department of Biomedical Informatics and Division of Pathology Informatics created a Science, Technology, Engineering, and Mathematics (STEM pipeline in 2011 dedicated to providing cutting-edge informatics research and career preparatory experiences to a diverse group of highly motivated high-school students. In this third editorial installment describing the program, we provide a brief overview of the pipeline, report on achievements of the past scholars, and present results from self-reported assessments by the 2015 cohort of scholars. The pipeline continues to expand with the 2015 addition of the innovation internship, and the introduction of a program in 2016 aimed at offering first-time research experiences to undergraduates who are underrepresented in pathology and biomedical informatics. Achievements of program scholars include authorship of journal articles, symposium