Student evaluation of a problem-oriented module of clinical medicine within a revised dental curriculum.

Science.gov (United States)

Tack, C J; Plasschaert, A J M

2006-05-01

As part of a revised dental curriculum, a 3(rd) year module on medical subjects was developed based on a mixture of self-study and problem-oriented approach using cases. Pairs of students had to select a specific medical problem and solve a paper patient case using a problem-solving cycle. Results were presented in working groups and by writing an essay. The quality of the presentations was assessed by colleague students and by the teacher supervisor; the expert teacher in the field graded the essay. The results contributed for 40% to the overall grade of the module. A questionnaire filled out by 94% of the participating students showed that 85% of the students agreed in preferring this way of handling medical problems as compared with conventional, lecture-based education. Almost all of them enjoyed the provided opportunity to give a case presentation. The problem-oriented model was assessed as useful by 73% of the students. Knowledge concerning the topic chosen turned out to be higher than knowledge of other topics. Although this study cannot prove that this mode of education actually results in a better ability to cope with medical problems, it may contribute in several ways to the final competences in the area of general medicine in the undergraduate dental curriculum.

Reflecting on the ethical administration of computerized medical records

Science.gov (United States)

Collmann, Jeff R.

1995-05-01

This presentation examines the ethical issues raised by computerized image management and communication systems (IMAC), the ethical principals that should guide development of policies, procedures and practices for IMACS systems, and who should be involved in developing a hospital's approach to these issues. The ready access of computerized records creates special hazards of which hospitals must beware. Hospitals must maintain confidentiality of patient's records while making records available to authorized users as efficiently as possible. The general conditions of contemporary health care undermine protecting the confidentiality of patient record. Patients may not provide health care institutions with information about themselves under conditions of informed consent. The field of information science must design sophisticated systems of computer security that stratify access, create audit trails on data changes and system use, safeguard patient data from corruption, and protect the databases from outside invasion. Radiology professionals must both work with information science experts in their own hospitals to create institutional safeguards and include the adequacy of security measures as a criterion for evaluating PACS systems. New policies and procedures on maintaining computerized patient records must be developed that obligate all members of the health care staff, not just care givers. Patients must be informed about the existence of computerized medical records, the rules and practices that govern their dissemination and given the opportunity to give or withhold consent for their use. Departmental and hospital policies on confidentiality should be reviewed to determine if revisions are necessary to manage computer-based records. Well developed discussions of the ethical principles and administrative policies on confidentiality and informed consent and of the risks posed by computer-based patient records systems should be included in initial and continuing

Interdisciplinary Problem Oriented Project Work

DEFF Research Database (Denmark)

Blomhøj, Morten; Kjeldsen, Tinne Hoff

2018-01-01

In this chapter, we analyze the problem oriented project work practiced at the Bachelor Study Program in Natural Science (Nat Bach) at Roskilde University (RU) as a learning environment for developing students’ mathematical modelling competence. The projects are conducted in a rather sophisticated...... and radical learning environment grounded on the four pedagogical key principles of, problem orientation, participant directed group work, interdisciplinarity and exemplarity. We illustrate and discuss the interplay between the aim of developing the students’ modelling competence on the one hand...

Use of web services for computerized medical decision support, including infection control and antibiotic management, in the intensive care unit.

Science.gov (United States)

Steurbaut, Kristof; Van Hoecke, Sofie; Colpaert, Kirsten; Lamont, Kristof; Taveirne, Kristof; Depuydt, Pieter; Benoit, Dominique; Decruyenaere, Johan; De Turck, Filip

2010-01-01

The increasing complexity of procedures in the intensive care unit (ICU) requires complex software services, to reduce improper use of antibiotics and inappropriate therapies, and to offer earlier and more accurate detection of infections and antibiotic resistance. We investigated whether web-based software can facilitate the computerization of complex medical processes in the ICU. The COSARA application contains the following modules: Infection overview, Thorax, Microbiology, Antibiotic therapy overview, Admission cause with comorbidity and admission diagnosis, Infection linking and registration, and Feedback. After the implementation and test phase, the COSARA software was installed on a physician's office PC and then on the bedside PCs of the patients. Initial evaluation indicated that the services had been integrated easily into the daily clinical workflow of the medical staff. The use of a service oriented architecture with web service technology for the development of advanced decision support in the ICU offers several advantages over classical software design approaches.

Unleashing the Effectiveness of Process-oriented Information Systems: Problem Analysis, Critical Success Factors, Implications

NARCIS (Netherlands)

Mutschler, B.B.; Reichert, M.U.; Bumiller, J.

2008-01-01

Process-oriented information systems (IS) aim at the computerized support of business processes. So far, contemporary IS have often fail to meet this goal. To better understand this drawback, to systematically identify its rationales, and to derive critical success factors for business process

A computerised out-patient medical records programme based on the Summary Time-Oriented Record (STOR) System.

Science.gov (United States)

Cheong, P Y; Goh, L G; Ong, R; Wong, P K

1992-12-01

Advances in microcomputer hardware and software technology have made computerised outpatient medical records practical. We have developed a programme based on the Summary Time-Oriented Record (STOR) system which complements existing paper-based record keeping. The elements of the Problem Oriented Medical Record (POMR) System are displayed in two windows within one screen, namely, the SOAP (Subjective information, Objective information, Assessments and Plans) elements in the Reason For Encounter (RFE) window and the problem list with outcomes in the Problem List (PL) window. Context sensitive child windows display details of plans of management in the RFE window and clinical notes in the PL window. The benefits of such innovations to clinical decision making and practice based research and its medico-legal implications are discussed.

Identification of drug-related problems by a clinical pharmacist in addition to computerized alerts

NARCIS (Netherlands)

Zaal, R.J.; Jansen, M.; Duisenberg-van Essenberg, M.; C.C., Tijssen; Roukema, J.A.; van den Bemt, P.M.

2013-01-01

Background Both clinical pharmacists and computerized physician order entry systems with clinical decision support (CPOE/CDSS) can reduce drug-related problems (DRPs). However, the contribution of a clinical pharmacist in addition to CPOE/CDSS has not been established in a prospective study.

Identification of drug-related problems by a clinical pharmacist in addition to computerized alerts

NARCIS (Netherlands)

R.J. Zaal (Rianne); M.M.P.M. Jansen (Mark M. P.); M. Duisenberg-Van Essenberg (Marjolijn); C.C. Tijssen (Cees); J.A. Roukema; P.M.L.A. van den Bemt (Patricia)

2013-01-01

textabstractBackground Both clinical pharmacists and computerized physician order entry systems with clinical decision support (CPOE/CDSS) can reduce drug-related problems (DRPs). However, the contribution of a clinical pharmacist in addition to CPOE/CDSS has not been established in a prospective

[Introduction of computerized anesthesia-recording systems and construction of comprehensive medical information network for patients undergoing surgery in the University of Tokyo Hospital].

Science.gov (United States)

Kitamura, Takayuki; Hoshimoto, Hiroyuki; Yamada, Yoshitsugu

2009-10-01

The computerized anesthesia-recording systems are expensive and the introduction of the systems takes time and requires huge effort. Generally speaking, the efficacy of the computerized anesthesia-recording systems on the anesthetic managements is focused on the ability to automatically input data from the monitors to the anesthetic records, and tends to be underestimated. However, once the computerized anesthesia-recording systems are integrated into the medical information network, several features, which definitely contribute to improve the quality of the anesthetic management, can be developed; for example, to prevent misidentification of patients, to prevent mistakes related to blood transfusion, and to protect patients' personal information. Here we describe our experiences of the introduction of the computerized anesthesia-recording systems and the construction of the comprehensive medical information network for patients undergoing surgery in The University of Tokyo Hospital. We also discuss possible efficacy of the comprehensive medical information network for patients during surgery under anesthetic managements.

Problem-Oriented Requirements in Practice

DEFF Research Database (Denmark)

Lauesen, Søren

2018-01-01

[Context and motivation] Traditional requirements describe what the system shall do. This gives suppliers little freedom to use what they have already. In contrast, problem-oriented requirements describe the customer’s demands: what he wants to use the system for and which problems he wants...... to remove. The supplier specifies how his system will deal with these issues. The author developed the problem-oriented approach in 2007 on request from the Danish Government, and named it SL-07. [Question/problem] SL-07 has been used in many projects – usually with success. However, we had no detailed re......¬ports of the effects. [Princi¬pal ideas/results] This paper is a case study of SL-07 in acquisition of a complex case-management system. The author wrote the requirements and managed the supplier selection. Next, he was asked to run the entire acquisition project, although he was a novice project manager. Some...

Object-orientated DBMS techniques for time-oriented medical record.

Science.gov (United States)

Pinciroli, F; Combi, C; Pozzi, G

1992-01-01

In implementing time-orientated medical record (TOMR) management systems, use of a relational model played a big role. Many applications have been developed to extend query and data manipulation languages to temporal aspects of information. Our experience in developing TOMR revealed some deficiencies inside the relational model, such as: (a) abstract data type definition; (b) unified view of data, at a programming level; (c) management of temporal data; (d) management of signals and images. We identified some first topics to face by an object-orientated approach to database design. This paper describes the first steps in designing and implementing a TOMR by an object-orientated DBMS.

Computerizing primary schools in rural kenya

DEFF Research Database (Denmark)

Ogembo, J.G.; Ngugi, B.; Pelowski, Matthew John

2012-01-01

questions surrounding this endeavour. Specifically: 1.) what problems do rural schools actually want to solve with computerization; 2.) is computerization the most important priority for rural schools; 3.) are schools ready, in terms of infrastructure, for a computer in the classroom; or 4.) might...... and protective roofing -posing severe challenges to the outstanding conception of computerization. We consider these results and make recommendations for better adapting programs for computer introduction, and also suggest the use of new innovative devices, such as cell phones, which might already have overcome......This paper investigates the outstanding challenges facing primary schools' computerization in rural Kenya. Computerization of schools is often envisaged as a 'magic', or at least a particularly efficient, solution to many of the problems that developing countries face in improving primary school...

Using Problem-solving Therapy to Improve Problem-solving Orientation, Problem-solving Skills and Quality of Life in Older Hemodialysis Patients.

Science.gov (United States)

Erdley-Kass, Shiloh D; Kass, Darrin S; Gellis, Zvi D; Bogner, Hillary A; Berger, Andrea; Perkins, Robert M

2017-08-24

To determine the effectiveness of Problem-Solving Therapy (PST) in older hemodialysis (HD) patients by assessing changes in health-related quality of life and problem-solving skills. 33 HD patients in an outpatient hemodialysis center without active medical and psychiatric illness were enrolled. The intervention group (n = 15) received PST from a licensed social worker for 6 weeks, whereas the control group (n = 18) received usual care treatment. In comparison to the control group, patients receiving PST intervention reported improved perceptions of mental health, were more likely to view their problems with a positive orientation and were more likely to use functional problem-solving methods. Furthermore, this group was also more likely to view their overall health, activity limits, social activities and ability to accomplish desired tasks with a more positive mindset. The results demonstrate that PST may positively impact mental health components of quality of life and problem-solving coping among older HD patients. PST is an effective, efficient, and easy to implement intervention that can benefit problem-solving abilities and mental health-related quality of life in older HD patients. In turn, this will help patients manage their daily living activities related to their medical condition and reduce daily stressors.

Tracks to a Medical Diagnosis: Expertise Differences in Visual Problem Solving

NARCIS (Netherlands)

Jaarsma, Thomas; Boshuizen, Els; Jarodzka, Halszka; Nap, Marius; Verboon, Peter; Van Merriënboer, Jeroen

2018-01-01

This study focuses on the visual problem-solving process of clinical pathologists. Its aim is to find expertise-related differences in the temporal arrangement of this process, with a special focus on the orientation phase. A theoretical model of the visual diagnostic process of medical specialists

A shared computer-based problem-oriented patient record for the primary care team.

Science.gov (United States)

Linnarsson, R; Nordgren, K

1995-01-01

1. INTRODUCTION. A computer-based patient record (CPR) system, Swedestar, has been developed for use in primary health care. The principal aim of the system is to support continuous quality improvement through improved information handling, improved decision-making, and improved procedures for quality assurance. The Swedestar system has evolved during a ten-year period beginning in 1984. 2. SYSTEM DESIGN. The design philosophy is based on the following key factors: a shared, problem-oriented patient record; structured data entry based on an extensive controlled vocabulary; advanced search and query functions, where the query language has the most important role; integrated decision support for drug prescribing and care protocols and guidelines; integrated procedures for quality assurance. 3. A SHARED PROBLEM-ORIENTED PATIENT RECORD. The core of the CPR system is the problem-oriented patient record. All problems of one patient, recorded by different members of the care team, are displayed on the problem list. Starting from this list, a problem follow-up can be made, one problem at a time or for several problems simultaneously. Thus, it is possible to get an integrated view, across provider categories, of those problems of one patient that belong together. This shared problem-oriented patient record provides an important basis for the primary care team work. 4. INTEGRATED DECISION SUPPORT. The decision support of the system includes a drug prescribing module and a care protocol module. The drug prescribing module is integrated with the patient records and includes an on-line check of the patient's medication list for potential interactions and data-driven reminders concerning major drug problems. Care protocols have been developed for the most common chronic diseases, such as asthma, diabetes, and hypertension. The patient records can be automatically checked according to the care protocols. 5. PRACTICAL EXPERIENCE. The Swedestar system has been implemented in a

Integrating traditional nursing service orientation content with electronic medical record orientation.

Science.gov (United States)

Harton, Brenda B; Borrelli, Larry; Knupp, Ann; Rogers, Necolen; West, Vickie R

2009-01-01

Traditional nursing service orientation classes at an acute care hospital were integrated with orientation to the electronic medical record to blend the two components in a user-friendly format so that the learner is introduced to the culture, processes, and documentation methods of the organization, with an opportunity to document online in a practice domain while lecture and discussion information is fresh.

Computerized tomographic in non-destructive testing

International Nuclear Information System (INIS)

Lopes, R.T.

1988-01-01

The process of computerized tomography has been developed for medical imaging purposes using tomographs with X-ray, and little attention has been given to others possibles applications of technique, because of its cost. As an alternative for the problem, we constructed a Tomographic System (STAC-1), using gamma-rays, for nonmedical applications. In this work we summarize the basic theory of reconstructing images using computerized tomography and we describe the considerations leading to the development of the experimental system. The method of reconstruction image implanted in the system is the filtered backprojection or convolution, with a digital filters system to carried on a pre-filtering in the projections. The experimental system is described, with details of control and the data processing. An alternative and a complementary system, using film as a detector is shown in preliminary form . This thesis discuss and shows the theorical and practical aspects, considered in the construction of the STAC-1, and also its limitations and apllications [pt

On the article of V. A. Mashin 'Computerized systems of NPP operators support. (Psychological problems)'

International Nuclear Information System (INIS)

Prushinskij, B.Ya.

1995-01-01

Basic aspects of V.A. Mashin's article on NPP operator support computerized systems and problems of man-machine interrelation are analyzed. Sharing in the significant degree Mashin's point of view the author of this article considers that the most important aspects of this problem consist in dividing the responsibility for NPP safe operation between all participants of the NPP creation and operation and in the area of practical experience in assuring control functions reliability

Problem-based and project-oriented learning

DEFF Research Database (Denmark)

Blaabjerg, Frede; Teodorescu, Remus; Chen, Zhe

2005-01-01

. Generally, the content of the curriculum should be more expanded without extra study time. This paper presents a teaching approach, which makes it possible very fast for the students to obtain in-depth skills into new research areas, and this method is the problem-oriented and project-based learning....... In this paper the necessary skills for power electronic engineers are outlined that is followed up by a description on how the problem-oriented and project-based learning are implemented. A complete curriculum in power electronics and drives at Aalborg University is presented where different power electronics...... related projects at different study levels also are presented....

Collaborative diagramming during problem based learning in medical education: Do computerized diagrams support basic science knowledge construction?

NARCIS (Netherlands)

de Leng, Bas; Gijlers, Aaltje H.

2015-01-01

Aim: To examine how collaborative diagramming affects discussion and knowledge construction when learning complex basic science topics in medical education, including its effectiveness in the reformulation phase of problem-based learning. Methods: Opinions and perceptions of students (n = 70) and

The Reliability and Validity of the Dominic Interactive: A Computerized Child Report Instrument for Mental Health Problems

NARCIS (Netherlands)

Kuijpers, R.C.W.M.; Otten, R.; Krol, N.P.C.M.; Vermulst, A.A.; Engels, R.C.M.E.

2013-01-01

Children and youths' self-report of mental health problems is considered essential but complicated. This study examines the psychometric properties of the Dominic Interactive, a computerized DSM-IV based self-report questionnaire and explores informant correspondence. The Dominic Interactive was

Gender roles, illness orientation and use of medical services.

Science.gov (United States)

Hibbard, J H; Pope, C R

1983-01-01

The study investigates illness orientation as a factor which may account for sex differences in the utilization of medical care. First, sex differences in the way symptoms are perceived, evaluated and acted upon (illness orientation) are analyzed. Then gender role factors which may account for sex differences in illness orientation are examined. Finally, the degree to which gender role factors and illness orientation account for sex differences in medical care utilization are assessed. The study population includes 1648 adults between the ages of 18 and 59. Medical record data covering 7 years of outpatient services are linked with survey data on the respondents. The findings show that while females are more likely to perceive symptoms than males, there is no apparent sex difference in a tendency to adopt the sick role when ill. In addition, results indicate that gender role factors such as level and type of role responsibility and concern with health are related to female though not male symptom reports. Illness orientation variables are related to rates of medical utilization for both sexes. However, it is primarily the perception of symptoms and an interest and concern with health which contributes to sex differences in utilization rates. When examining respondents who report either a very low or very high number of symptoms, sex differences in utilization rates fall below statistical significance.

A neural network approach to the orienteering problem

Energy Technology Data Exchange (ETDEWEB)

Golden, B.; Wang, Q.; Sun, X.; Jia, J.

1994-12-31

In the orienteering problem, we are given a transportation network in which a start point and an end point are specified. Other points have associated scores. Given a fixed amount of time, the goal is to determine a path from start to end through a subset of locations in order to maximize the total path score. This problem has received a considerable amount of attention in the last ten years. The TSP is a variant of the orienteering problem. This paper applies a modified, continuous Hopfield neural network to attack this NP-hard optimization problem. In it, we design an effective energy function and learning algorithm. Unlike some applications of neural networks to optimization problems, this approach is shown to perform quite well.

Comparison between Long-Menu and Open-Ended Questions in computerized medical assessments. A randomized controlled trial

Directory of Open Access Journals (Sweden)

Fischer Martin R

2006-10-01

Full Text Available Abstract Background Long-menu questions (LMQs are viewed as an alternative method for answering open-ended questions (OEQs in computerized assessment. So far this question type and its influence on examination scores have not been studied sufficiently. However, the increasing use of computerized assessments will also lead to an increasing use of this question type. Using a summative online key feature (KF examination we evaluated whether LMQs can be compared with OEQs in regard to the level of difficulty, performance and response times. We also evaluated the content for its suitability for LMQs. Methods We randomized 146 fourth year medical students into two groups. For the purpose of this study we created 7 peer-reviewed KF-cases with a total of 25 questions. All questions had the same content in both groups, but nine questions had a different answer type. Group A answered 9 questions with an LM type, group B with an OE type. In addition to the LM answer, group A could give an OE answer if the appropriate answer was not included in the list. Results The average number of correct answers for LMQs and OEQs showed no significant difference (p = 0.93. Among all 630 LM answers only one correct term (0.32% was not included in the list of answers. The response time for LMQs did not significantly differ from that of OEQs (p = 0.65. Conclusion LMQs and OEQs do not differ significantly. Compared to standard multiple-choice questions (MCQs, the response time for LMQs and OEQs is longer. This is probably due to the fact that they require active problem solving skills and more practice. LMQs correspond more suitable to Short answer questions (SAQ then to OEQ and should only be used when the answers can be clearly phrased, using only a few, precise synonyms. LMQs can decrease cueing effects and significantly simplify the scoring in computerized assessment.

Medical students' learning orientation regarding interracial interactions affects preparedness to care for minority patients: a report from Medical Student CHANGES.

Science.gov (United States)

Burgess, Diana J; Burke, Sara E; Cunningham, Brooke A; Dovidio, John F; Hardeman, Rachel R; Hou, Yuefeng; Nelson, David B; Perry, Sylvia P; Phelan, Sean M; Yeazel, Mark W; van Ryn, Michelle

2016-09-29

There is a paucity of evidence on how to train medical students to provide equitable, high quality care to racial and ethnic minority patients. We test the hypothesis that medical schools' ability to foster a learning orientation toward interracial interactions (i.e., that students can improve their ability to successfully interact with people of another race and learn from their mistakes), will contribute to white medical students' readiness to care for racial minority patients. We then test the hypothesis that white medical students who perceive their medical school environment as supporting a learning orientation will benefit more from disparities training. Prospective observational study involving web-based questionnaires administered during first (2010) and last (2014) semesters of medical school to 2394 white medical students from a stratified, random sample of 49 U.S. medical schools. Analysis used data from students' last semester to build mixed effects hierarchical models in order to assess the effects of medical school interracial learning orientation, calculated at both the school and individual (student) level, on key dependent measures. School differences in learning orientation explained part of the school difference in readiness to care for minority patients. However, individual differences in learning orientation accounted for individual differences in readiness, even after controlling for school-level learning orientation. Individual differences in learning orientation significantly moderated the effect of disparities training on white students' readiness to care for minority patients. Specifically, white medical students who perceived a high level of learning orientation in their medical schools regarding interracial interactions benefited more from training to address disparities. Coursework aimed at reducing healthcare disparities and improving the care of racial minority patients was only effective when white medical students perceived their

Object-oriented design of medical imaging software.

Science.gov (United States)

Ligier, Y; Ratib, O; Logean, M; Girard, C; Perrier, R; Scherrer, J R

1994-01-01

A special software package for interactive display and manipulation of medical images was developed at the University Hospital of Geneva, as part of a hospital wide Picture Archiving and Communication System (PACS). This software package, called Osiris, was especially designed to be easily usable and adaptable to the needs of noncomputer-oriented physicians. The Osiris software has been developed to allow the visualization of medical images obtained from any imaging modality. It provides generic manipulation tools, processing tools, and analysis tools more specific to clinical applications. This software, based on an object-oriented paradigm, is portable and extensible. Osiris is available on two different operating systems: the Unix X-11/OSF-Motif based workstations, and the Macintosh family.

Medical teachers' attitudes towards science and motivational orientation for medical research.

Science.gov (United States)

Cvek, Mario; Hren, Darko; Sambunjak, Dario; Planinc, Mislav; Macković, Maja; Marusić, Ana; Marusić, Matko

2009-01-01

Research is an important motivating factor for pursuing a career in academic medicine, but the relation between motivation and other factors involved in scientific research are not clear. To explore the motivational orientation for doing research and its relation with attitudes towards science and publication practice among members of faculty at a medical school. We used a Science Attitude Survey and the Work Preference Inventory (intrinsic and extrinsic motivational orientation using 4 Likert-type scales of motivation, possible range 1-5) to survey two groups of teachers at the Zagreb University School of Medicine (n = 327, 66% response rate): professors, elected to tenure-track positions (n = 150), and instructor/research fellows working on or just completing their thesis (n = 177). Overall, teachers scored highest on the Enjoyment subscale of intrinsic motivational orientation (mean score +/- standard deviation 4.3 +/- 0.42 for professors vs 4.1 +/- 0.42 for instructors/research fellows, P = 0.001, t-test). Professors also scored higher than instructors/research fellows on the Challenge subscale of intrinsic motivational orientation (3.8 +/- 0.55 vs. 3.5 +/- 0.64, P motivational orientation (3.5 +/- 0.74 vs. 3.1 +/- 0.71, P motivation, and negatively associated with scores on the Compensation subscale of extrinsic motivation. Members of the medical faculty differ in motivational orientation for research depending on their academic status, and their motivation is associated more with requirements for academic advancement than with research. These findings have important implications for developing strategies for enhancing academic research production.

Unleashing the Effectiveness of Process-oriented Information Systems: Problem Analysis, Critical Success Factors, Implications

OpenAIRE

Mutschler, B.B.; Reichert, M.U.; Bumiller, J.

2008-01-01

Process-oriented information systems (IS) aim at the computerized support of business processes. So far, contemporary IS have often fail to meet this goal. To better understand this drawback, to systematically identify its rationales, and to derive critical success factors for business process support, we conducted three empirical studies: an exploratory case study in the automotive domain, an online survey among 79 IT professionals, and another online survey among 70 business process managem...

A multiple objective test assembly approach for exposure control problems in Computerized Adaptive Testing

Directory of Open Access Journals (Sweden)

Theo J.H.M. Eggen

2010-01-01

Full Text Available Overexposure and underexposure of items in the bank are serious problems in operational computerized adaptive testing (CAT systems. These exposure problems might result in item compromise, or point at a waste of investments. The exposure control problem can be viewed as a test assembly problem with multiple objectives. Information in the test has to be maximized, item compromise has to be minimized, and pool usage has to be optimized. In this paper, a multiple objectives method is developed to deal with both types of exposure problems. In this method, exposure control parameters based on observed exposure rates are implemented as weights for the information in the item selection procedure. The method does not need time consuming simulation studies, and it can be implemented conditional on ability level. The method is compared with Sympson Hetter method for exposure control, with the Progressive method and with alphastratified testing. The results show that the method is successful in dealing with both kinds of exposure problems.

Mixed results in the safety performance of computerized physician order entry.

Science.gov (United States)

Metzger, Jane; Welebob, Emily; Bates, David W; Lipsitz, Stuart; Classen, David C

2010-04-01

Computerized physician order entry is a required feature for hospitals seeking to demonstrate meaningful use of electronic medical record systems and qualify for federal financial incentives. A national sample of sixty-two hospitals voluntarily used a simulation tool designed to assess how well safety decision support worked when applied to medication orders in computerized order entry. The simulation detected only 53 percent of the medication orders that would have resulted in fatalities and 10-82 percent of the test orders that would have caused serious adverse drug events. It is important to ascertain whether actual implementations of computerized physician order entry are achieving goals such as improved patient safety.

Oriental Medical Treatment of Lumbar Spinal Stenosis

Directory of Open Access Journals (Sweden)

Hae-Yeon Lee

2003-12-01

Full Text Available Lumbar spinal stenosis results from the progressive combined narrowing of the central spinal canal, the neurorecesses, and the neuroforaminal canals. In the absence of prior surgery, tumor, or infection, the spinal canal may become narrowed by bulging or protrusion of the intervertebral disc annulus, herniation of the nucleus pulposis posteriorly, thickening of the posterior longitudinal ligament, hypertrophy of the ligamentum flavum, epidural fat deposition, spondylosis of the intervertebral disc margins, or a combination of two or more of the above factors. Patients with spinal stenosis become symptomatic when pain, motor weakness, paresthesia, or other neurologic compromise causes distress. In one case, we administrated oriental medical treatment with acupuncture treatment and herb-medicine. Oriental medical treatment showed desirable effect on lumbar spinal stenosis.

The limited angle problem in computerized tomography

International Nuclear Information System (INIS)

Louis, A.K.

1984-01-01

Fast reconstruction formulae in X-ray computerized tomography demand the directions, in which the measurements are taken, to be equally distributed over the whole circle. In many applications data can only be provided in a restricted range. Here the intrinsic difficulties are studied by giving a singular value decomposition of the Radon transform in a restricted range. Practical limitations are deduced. (orig.)

Problem-oriented approach to Ancient philosophy

Directory of Open Access Journals (Sweden)

Berstov, Igor

2007-06-01

Full Text Available Igor Berestov and Marina Wolf of the Institute of philosophy and law, Novosibirsk, discuss various methodological difficulties typical of studies in the history of Ancient Greek philosophy and try to develop their own problem-oriented approach.

Benefit of Problem-Based Learning for Psychosocial Medicine: first experiences at the medical faculty of berne

OpenAIRE

Laederach-Hofmann, Kurt; Stadelmann, Barbara; Isenschmid, Bettina

2005-01-01

Aim: Presentation of skills and knowledge of medical students in psychiatry or psychosocial medicine in basic study (year 1 to 3) after the introduction of a problem oriented learning curriculum at the Medical Faculty of Berne.Method: Description of the curriculum with the different teaching units, and the evaluation by means of formative tools used by students and tutors.Results: With reference to qualitative comparison students of the problem based learning track showed a better preparation...

Sex differences in interpersonal problems: does sexual orientation moderate?

Science.gov (United States)

Lee, Debbiesiu L; Harkless, Lynn E; Sheridan, Daniel J; Winakur, Emily; Fowers, Blaine J

2013-01-01

Sexual orientation was examined as a moderator in the relation between biological sex and interpersonal problems. Participants were 60 lesbians, 45 heterosexual women, 37 gay men, and 39 heterosexual men, who completed the Inventory of Interpersonal Problems-Circumplex. Sexual orientation was found to moderate one of the eight interpersonal problems under study. Heterosexual women scored significantly higher than lesbian women in Non-assertive. Although hypothesized, gay men did not differ from heterosexual men along the Dominant-Cold quadrant. Implications of these results are discussed.

The difference between problem-oriented education and problem based learning

DEFF Research Database (Denmark)

Olsen, Poul Bitsch

2013-01-01

Roskilde University offers a distinctive profile and contribution within Denmark. It is well known for its interdisciplinary research and education, including project work and problem-oriented method that is much valued by its students and graduates (International Evaluation Report on Roskilde...

Personality Traits, Sexual Problems, and Sexual Orientation: An Empirical Study.

Science.gov (United States)

Peixoto, Maria Manuela; Nobre, Pedro

2016-01-01

Personality traits, namely neuroticism, have been suggested as vulnerability factors for the development and maintenance of sexual dysfunction in heterosexual samples. However, no evidence was found regarding homosexual samples. This study aimed to analyze the differences on personality traits between heterosexual and homosexual men and women with and without sexual problems. Participants were 285 individuals (142 men, 143 women) who completed a web-based survey. Participants answered the NEO Five-Factor Inventory, the Brief Symptomatology Inventory, and questions regarding sexual problems. The groups of men and women with and without sexual problems were matched for sociodemographic variables. A 2 (Group) × 2 (Sexual Orientation) multivariate analysis of covariance was conducted separately for each gender. Results indicated a significant main effect for group and for sexual orientation in male and female samples. Men with sexual problems scored higher on neuroticism, whereas women with sexual problems scored higher on neuroticism and lower on extraversion when compared with healthy controls, regardless of sexual orientation. In addition, gay men scored higher on neuroticism and lesbian women scored higher on conscientiousness compared with the heterosexual groups. The present findings emphasize the central role of neuroticism on sexual problems in both men and women regardless of sexual orientation.

The cost of problem-based vs traditional medical education.

Science.gov (United States)

Mennin, S P; Martinez-Burrola, N

1986-05-01

It is generally accepted that teachers' salaries are a major factor in the cost of medical education. Little is known about the effects of curriculum on teaching time. A comparison of teaching time devoted to each of two different medical education curricula is presented. In a traditional teacher-centered, subject-oriented curriculum, 61% of the total teaching effort expended by twenty-two teachers took place in the absence of students, i.e. in preparation for student contact. Only 39% of the effort devoted by these teachers to medical education took place in the presence of students. In a problem-based, student-centered curriculum which focuses upon small-group tutorial learning and early extended primary care experience in a rural community setting, 72% of the total teaching effort devoted to medical education was spent with students and only 28% was spent in preparation for student contact. Overall, there were no differences in the total amount of teaching time required by each of the two curricular approaches to medical education. There were, however, major differences in how teachers spent their teaching time.

PSYCHE: An Object-Oriented Approach to Simulating Medical Education

Science.gov (United States)

Mullen, Jamie A.

1990-01-01

Traditional approaches to computer-assisted instruction (CAI) do not provide realistic simulations of medical education, in part because they do not utilize heterogeneous knowledge bases for their source of domain knowledge. PSYCHE, a CAI program designed to teach hypothetico-deductive psychiatric decision-making to medical students, uses an object-oriented implementation of an intelligent tutoring system (ITS) to model the student, domain expert, and tutor. It models the transactions between the participants in complex transaction chains, and uses heterogeneous knowledge bases to represent both domain and procedural knowledge in clinical medicine. This object-oriented approach is a flexible and dynamic approach to modeling, and represents a potentially valuable tool for the investigation of medical education and decision-making.

An accurate and efficient identification of children with psychosocial problems by means of computerized adaptive testing

Directory of Open Access Journals (Sweden)

Reijneveld Symen A

2011-08-01

Full Text Available Abstract Background Questionnaires used by health services to identify children with psychosocial problems are often rather short. The psychometric properties of such short questionnaires are mostly less than needed for an accurate distinction between children with and without problems. We aimed to assess whether a short Computerized Adaptive Test (CAT can overcome the weaknesses of short written questionnaires when identifying children with psychosocial problems. Method We used a Dutch national data set obtained from parents of children invited for a routine health examination by Preventive Child Healthcare with 205 items on behavioral and emotional problems (n = 2,041, response 84%. In a random subsample we determined which items met the requirements of an Item Response Theory (IRT model to a sufficient degree. Using those items, item parameters necessary for a CAT were calculated and a cut-off point was defined. In the remaining subsample we determined the validity and efficiency of a Computerized Adaptive Test using simulation techniques, with current treatment status and a clinical score on the Total Problem Scale (TPS of the Child Behavior Checklist as criteria. Results Out of 205 items available 190 sufficiently met the criteria of the underlying IRT model. For 90% of the children a score above or below cut-off point could be determined with 95% accuracy. The mean number of items needed to achieve this was 12. Sensitivity and specificity with the TPS as a criterion were 0.89 and 0.91, respectively. Conclusion An IRT-based CAT is a very promising option for the identification of psychosocial problems in children, as it can lead to an efficient, yet high-quality identification. The results of our simulation study need to be replicated in a real-life administration of this CAT.

Enhanced exact solution methods for the Team Orienteering Problem

NARCIS (Netherlands)

Keshtkaran, M.; Ziarati, K.; Bettinelli, A.; Vigo, D.

2016-01-01

The Team Orienteering Problem (TOP) is one of the most investigated problems in the family of vehicle routing problems with profits. In this paper, we propose a Branch-and-Price approach to find proven optimal solutions to TOP. The pricing sub-problem is solved by a bounded bidirectional dynamic

Analysis of medication adherence-related notes from a service-oriented community pharmacy.

Science.gov (United States)

Witry, Matthew; Parry, Rachel; McDonough, Randal; Deninger, Michael

2017-07-15

Medication nonadherence is a significant public health problem. Community pharmacists are positioned to intervene, however, the process is not well understood. To classify and quantify the reasons for nonadherence documented by community pharmacists. A retrospective content analysis of pharmacist notes related to nonadherence at a service oriented community pharmacy in the Midwest United States. Notes from the site's dispensing custom documentation software were obtained from September 1, 2014 through February 28, 2015 that were labeled "compliance", either prompted by proportion of days covered calculations or entered as a drug therapy problem. A code list was iterated for the notes based on the literature and by reading the notes and generating descriptive codes. A reliability analysis was calculated for two coders. Notes were coded, check-coded, and discrepancies were resolved using a consensus process. Frequencies were calculated for each code and representative text was selected. Pharmacists documented 3491 notes as part of their continuous medication monitoring process. Nineteen codes were developed. The reliability for the coders had a Cohen's Kappa of 0.749. The majority of notes (61.4%) documented the pharmacist evaluated the refill and had no concerns or would continue to follow. Also documented were specific reasons for out of range PDCs not indicative of a nonadherence problem. Only 2.2% of notes specifically documented a nonadherence problem, such as forgetfulness or cost. While pharmacists encountered many false positive nonadherence alerts, following up with patients led to hundreds of discussions and clarifications about how patients use their medications at home. These results suggest a small minority of late refills are judged by pharmacists as indicative of an adherence problem, contrary to the prevailing literature. Pharmacists may benefit from modifying their approach to nonadherence interviewing and documentation as they seek to address

Quality criteria in computerized tomography of the chest

International Nuclear Information System (INIS)

Doehring, W.

1985-01-01

The quality of thoracical computerized tomography (CT) - like any other CT examination - depends from the quality of the equipment used, from the skill of the examinor and the properties of the patient. Concerning computerized chest tomograms, rapid scan equipment should be used only and slow translation - rotation systems should not be used any more. Whereas the quality of computerized tomograms may be influenced by the patient in the scanning process only, the examining physician will decisively influence the possible informative value of the examination also in the reconstruction of the CT value matrix, in single demonstration of CT values and, possibly, in additional measurement value processing as well as in the interpretation of findings. Use of equipment should always consider the technical potential provided by the equipment to be oriented to the clinical issue, and the conditions preset by the patient. (orig.) [de

Problem-oriented project studies

DEFF Research Database (Denmark)

Nielsen, Jørgen Lerche; Danielsen, Oluf

2010-01-01

and marking papers / essays is complemented and in some way overruled by a new role as supervisor and facilitator for the group of students working with a research problem, they themselves have picked. However different dimensions of this new teacher role can be seen – from expert in an academic field (result......-oriented focusing on how the final product demonstrates the students’ ‘correct’ way to handle the academic aspects of the subject in mind) to a role more focusing on processes, methodological dimensions and stressing the importance of a reflexive approach. Some teachers may even tend to take on a role...

Service-Oriented Security Framework for Remote Medical Services in the Internet of Things Environment

Science.gov (United States)

Lee, Jae Dong; Yoon, Tae Sik; Chung, Seung Hyun

2015-01-01

Objectives Remote medical services have been expanding globally, and this is expansion is steadily increasing. It has had many positive effects, including medical access convenience, timeliness of service, and cost reduction. The speed of research and development in remote medical technology has been gradually accelerating. Therefore, it is expected to expand to enable various high-tech information and communications technology (ICT)-based remote medical services. However, the current state lacks an appropriate security framework that can resolve security issues centered on the Internet of things (IoT) environment that will be utilized significantly in telemedicine. Methods This study developed a medical service-oriented frame work for secure remote medical services, possessing flexibility regarding new service and security elements through its service-oriented structure. First, the common architecture of remote medical services is defined. Next medical-oriented secu rity threats and requirements within the IoT environment are identified. Finally, we propose a "service-oriented security frame work for remote medical services" based on previous work and requirements for secure remote medical services in the IoT. Results The proposed framework is a secure framework based on service-oriented cases in the medical environment. A com parative analysis focusing on the security elements (confidentiality, integrity, availability, privacy) was conducted, and the analysis results demonstrate the security of the proposed framework for remote medical services with IoT. Conclusions The proposed framework is service-oriented structure. It can support dynamic security elements in accordance with demands related to new remote medical services which will be diversely generated in the IoT environment. We anticipate that it will enable secure services to be provided that can guarantee confidentiality, integrity, and availability for all, including patients, non-patients, and medical

Service-Oriented Security Framework for Remote Medical Services in the Internet of Things Environment.

Science.gov (United States)

Lee, Jae Dong; Yoon, Tae Sik; Chung, Seung Hyun; Cha, Hyo Soung

2015-10-01

Remote medical services have been expanding globally, and this is expansion is steadily increasing. It has had many positive effects, including medical access convenience, timeliness of service, and cost reduction. The speed of research and development in remote medical technology has been gradually accelerating. Therefore, it is expected to expand to enable various high-tech information and communications technology (ICT)-based remote medical services. However, the current state lacks an appropriate security framework that can resolve security issues centered on the Internet of things (IoT) environment that will be utilized significantly in telemedicine. This study developed a medical service-oriented frame work for secure remote medical services, possessing flexibility regarding new service and security elements through its service-oriented structure. First, the common architecture of remote medical services is defined. Next medical-oriented secu rity threats and requirements within the IoT environment are identified. Finally, we propose a "service-oriented security frame work for remote medical services" based on previous work and requirements for secure remote medical services in the IoT. The proposed framework is a secure framework based on service-oriented cases in the medical environment. A com parative analysis focusing on the security elements (confidentiality, integrity, availability, privacy) was conducted, and the analysis results demonstrate the security of the proposed framework for remote medical services with IoT. The proposed framework is service-oriented structure. It can support dynamic security elements in accordance with demands related to new remote medical services which will be diversely generated in the IoT environment. We anticipate that it will enable secure services to be provided that can guarantee confidentiality, integrity, and availability for all, including patients, non-patients, and medical staff.

Enhancing the efficacy of computerized feedback interventions for college alcohol misuse: An exploratory randomized trial.

Science.gov (United States)

Miller, Mary Beth; Leavens, Eleanor L; Meier, Ellen; Lombardi, Nathaniel; Leffingwell, Thad R

2016-02-01

Personalized feedback interventions (PFIs) have been associated with decreased alcohol consumption and related problems among college students; however, the necessary and sufficient components responsible for efficacy remain unclear. The present study investigated the relative efficacy of 3 computerized PFIs with differing content, the content-specific mechanisms of change within PFIs, and the moderating roles of comparison orientation and baseline risk in intervention outcomes. College students (N = 212) reporting alcohol use in a typical week completed an assessment prior to randomization (norms PFI, enhanced PFI, choice PFI, assessment only) and 1 month postintervention. Participants who received a PFI reported greater decreases in alcohol use, peak blood alcohol concentration (BAC), related problems, and perceptions of typical students' drinking than those in the control group. Neither tendency to compare oneself with others nor baseline risk moderated outcomes. PFIs influenced weekly alcohol use indirectly through changes in descriptive normative perceptions and alcohol-related consequences indirectly through changes in peak BAC. Computerized PFIs are more effective than assessment alone in decreasing alcohol use and related problems among college students. Normative comparisons may be sufficient to elicit behavior change, and inclusion of select additional components may not yield significant improvements in outcomes. However, the consistent benefit of including feedback on physical and monetary costs of drinking and moderation strategies, although nonsignificant, may warrant the negligible increase in time and money required to provide such information electronically. Computerized PFIs seem to be an ideal first step to the prevention and treatment of college alcohol misuse. (c) 2016 APA, all rights reserved).

Improving the human readability of Arden Syntax medical logic modules using a concept-oriented terminology and object-oriented programming expressions.

Science.gov (United States)

Choi, Jeeyae; Bakken, Suzanne; Lussier, Yves A; Mendonça, Eneida A

2006-01-01

Medical logic modules are a procedural representation for sharing task-specific knowledge for decision support systems. Based on the premise that clinicians may perceive object-oriented expressions as easier to read than procedural rules in Arden Syntax-based medical logic modules, we developed a method for improving the readability of medical logic modules. Two approaches were applied: exploiting the concept-oriented features of the Medical Entities Dictionary and building an executable Java program to replace Arden Syntax procedural expressions. The usability evaluation showed that 66% of participants successfully mapped all Arden Syntax rules to Java methods. These findings suggest that these approaches can play an essential role in the creation of human readable medical logic modules and can potentially increase the number of clinical experts who are able to participate in the creation of medical logic modules. Although our approaches are broadly applicable, we specifically discuss the relevance to concept-oriented nursing terminologies and automated processing of task-specific nursing knowledge.

Evaluation of computerized health management information system for primary health care in rural India

Directory of Open Access Journals (Sweden)

Singh Satyavir

2010-11-01

Full Text Available Abstract Background The Comprehensive Rural Health Services Project Ballabgarh, run by All India Institute of Medical Sciences (AIIMS, New Delhi has a computerized Health Management Information System (HMIS since 1988. The HMIS at Ballabgarh has undergone evolution and is currently in its third version which uses generic and open source software. This study was conducted to evaluate the effectiveness of a computerized Health Management Information System in rural health system in India. Methods The data for evaluation were collected by in-depth interviews of the stakeholders i.e. program managers (authors and health workers. Health Workers from AIIMS and Non-AIIMS Primary Health Centers were interviewed to compare the manual with computerized HMIS. A cost comparison between the two methods was carried out based on market costs. The resource utilization for both manual and computerized HMIS was identified based on workers' interviews. Results There have been no major hardware problems in use of computerized HMIS. More than 95% of data was found to be accurate. Health workers acknowledge the usefulness of HMIS in service delivery, data storage, generation of workplans and reports. For program managers, it provides a better tool for monitoring and supervision and data management. The initial cost incurred in computerization of two Primary Health Centers was estimated to be Indian National Rupee (INR 1674,217 (USD 35,622. Equivalent annual incremental cost of capital items was estimated as INR 198,017 (USD 4213. The annual savings is around INR 894,283 (USD 11,924. Conclusion The major advantage of computerization has been in saving of time of health workers in record keeping and report generation. The initial capital costs of computerization can be recovered within two years of implementation if the system is fully operational. Computerization has enabled implementation of a good system for service delivery, monitoring and supervision.

Computerized micrographics in processing hard-copy records for an epidemiologic study

International Nuclear Information System (INIS)

Robie, D.M.; Fry, S.A.

1983-01-01

The availability of computers with increasing capabilities has made feasibile epidemiologic studies involving large populations such as those utilized to evaluate the health effects of occupational exposure to radiation. However, the storage and retrieval of data from the large numbers of hard-copy personnel, health physics, employment medical, historical or anecdotal documents that are the bases of such studies pose major logistics problems to investigators. The potential value of such records to epidemiologic studies depends, not only on their accuracy and completeness, but also on ease of accessibility. To address the latter problem, we are using a stand-alone user-oriented electronic filing system that records, stores, and secures hard-copy documents micrographically. This system is controlled by a computer that provides retrieval of a document image and printed copy (if desired) in less than 30 seconds from a maximum of eight fields. One thousand documents are randomly filmed and indexed on computer storage diskettes in two hours. Manual sorting and filing of the same number of documents takes over a day. At present two thousand documents can be recorded on each microfilm roll and 85,000 documents indexed on each diskette. Simultaneous searching for documents can be done using up to ten terminals while indexing is being done at the main terminal. The micrographics system provides the space-saving and security advantages of microfilm with the speed of computerized data retrieval

Application of Fuzzy Optimization to the Orienteering Problem

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Madhushi Verma

2015-01-01

Full Text Available This paper deals with the orienteering problem (OP which is a combination of two well-known problems (i.e., travelling salesman problem and the knapsack problem. OP is an NP-hard problem and is useful in appropriately modeling several challenging applications. As the parameters involved in these applications cannot be measured precisely, depicting them using crisp numbers is unrealistic. Further, the decision maker may be satisfied with graded satisfaction levels of solutions, which cannot be formulated using a crisp program. To deal with the above-stated two issues, we formulate the fuzzy orienteering problem (FOP and provide a method to solve it. Here we state the two necessary conditions of OP of maximizing the total collected score and minimizing the time taken to traverse a path (within the specified time bound as fuzzy goals and the remaining necessary conditions as crisp constraints. Using the max-min formulation of the fuzzy sets obtained from the fuzzy goals, we calculate the fuzzy decision sets (Z and Z∗ that contain the feasible paths and the desirable paths, respectively, along with the degrees to which they are acceptable. To efficiently solve large instances of FOP, we also present a parallel algorithm on CREW PRAM model.

Exact Algorithm for the Capacitated Team Orienteering Problem with Time Windows

Directory of Open Access Journals (Sweden)

Junhyuk Park

2017-01-01

Full Text Available The capacitated team orienteering problem with time windows (CTOPTW is a problem to determine players’ paths that have the maximum rewards while satisfying the constraints. In this paper, we present the exact solution approach for the CTOPTW which has not been done in previous literature. We show that the branch-and-price (B&P scheme which was originally developed for the team orienteering problem can be applied to the CTOPTW. To solve pricing problems, we used implicit enumeration acceleration techniques, heuristic algorithms, and ng-route relaxations.

Determination of optimal self-drive tourism route using the orienteering problem method

Science.gov (United States)

Hashim, Zakiah; Ismail, Wan Rosmanira; Ahmad, Norfaieqah

2013-04-01

This paper was conducted to determine the optimal travel routes for self-drive tourism based on the allocation of time and expense by maximizing the amount of attraction scores assigned to each city involved. Self-drive tourism represents a type of tourism where tourists hire or travel by their own vehicle. It only involves a tourist destination which can be linked with a network of roads. Normally, the traveling salesman problem (TSP) and multiple traveling salesman problems (MTSP) method were used in the minimization problem such as determination the shortest time or distance traveled. This paper involved an alternative approach for maximization method which is maximize the attraction scores and tested on tourism data for ten cities in Kedah. A set of priority scores are used to set the attraction score at each city. The classical approach of the orienteering problem was used to determine the optimal travel route. This approach is extended to the team orienteering problem and the two methods were compared. These two models have been solved by using LINGO12.0 software. The results indicate that the model involving the team orienteering problem provides a more appropriate solution compared to the orienteering problem model.

Examining Sexual Orientation Disparities in Unmet Medical Needs among Men and Women.

Science.gov (United States)

Everett, Bethany G; Mollborn, Stefanie

2014-08-01

Using the National Longitudinal Study of Adolescent Health (N = 13,810), this study examines disparities in unmet medical needs by sexual orientation identity during young adulthood. We use binary logistic regression and expand Andersen's health care utilization framework to identify factors that shape disparities in unmet medical needs by sexual orientation. We also investigate whether the well-established gender disparity in health-seeking behaviors among heterosexual persons holds for sexual minorities. The results show that sexual minority women are more likely to report unmet medical needs than heterosexual women, but no differences are found between sexual minority and heterosexual men. Moreover, we find a reversal in the gender disparity between heterosexual and sexual minority populations: heterosexual women are less likely to report unmet medical needs than heterosexual men, whereas sexual minority women are more likely to report unmet medical needs compared to sexual minority men. Finally, this work advances Andersen's model by articulating the importance of including social psychological factors for reducing disparities in unmet medical needs by sexual orientation for women.

Examining Sexual Orientation Disparities in Unmet Medical Needs among Men and Women

Science.gov (United States)

Everett, Bethany G.; Mollborn, Stefanie

2013-01-01

Using the National Longitudinal Study of Adolescent Health (N = 13,810), this study examines disparities in unmet medical needs by sexual orientation identity during young adulthood. We use binary logistic regression and expand Andersen’s health care utilization framework to identify factors that shape disparities in unmet medical needs by sexual orientation. We also investigate whether the well-established gender disparity in health-seeking behaviors among heterosexual persons holds for sexual minorities. The results show that sexual minority women are more likely to report unmet medical needs than heterosexual women, but no differences are found between sexual minority and heterosexual men. Moreover, we find a reversal in the gender disparity between heterosexual and sexual minority populations: heterosexual women are less likely to report unmet medical needs than heterosexual men, whereas sexual minority women are more likely to report unmet medical needs compared to sexual minority men. Finally, this work advances Andersen’s model by articulating the importance of including social psychological factors for reducing disparities in unmet medical needs by sexual orientation for women. PMID:25382887

Computerized tomography

International Nuclear Information System (INIS)

Rubashov, I.B.

1985-01-01

Operating principle is described for the devices of computerized tomography used in medicine for diagnosis of brain diseases. Computerized tomography is considered as a part of computerized diagnosis, as a part of information science. It is shown that computerized tomography is a real existed field of investigations in medicine and industrial production

From primary care to public health: using Problem-based Learning and the ecological model to teach public health to first year medical students.

Science.gov (United States)

Hoover, Cora R; Wong, Candice C; Azzam, Amin

2012-06-01

We investigated whether a public health-oriented Problem-Based Learning case presented to first-year medical students conveyed 12 "Population Health Competencies for Medical Students," as recommended by the Association of American Medical Colleges and the Regional Medicine-Public Health Education Centers. A public health-oriented Problem-Based Learning case guided by the ecological model paradigm was developed and implemented among two groups of 8 students at the University of California, Berkeley-UCSF Joint Medical Program, in the Fall of 2010. Using directed content analysis, student-generated written reports were coded for the presence of the 12 population health content areas. Students generated a total of 29 reports, of which 20 (69%) contained information relevant to at least one of the 12 population health competencies. Each of the 12 content areas was addressed by at least one report. As physicians-in-training prepare to confront the challenges of integrating prevention and population health with clinical practice, Problem-Based Learning is a promising tool to enhance medical students' engagement with public health.

Social Orientation: Problem Behavior and Motivations Toward Interpersonal Problem Solving Among High Risk Adolescents

Science.gov (United States)

Kuperminc, Gabriel P.; Allen, Joseph P.

2006-01-01

A model of problematic adolescent behavior that expands current theories of social skill deficits in delinquent behavior to consider both social skills and orientation toward the use of adaptive skills was examined in an ethnically and socioeconomically diverse sample of 113 male and female adolescents. Adolescents were selected on the basis of moderate to serious risk for difficulties in social adaptation in order to focus on the population of youth most likely to be targeted by prevention efforts. Structural equation modeling was used to examine cross-sectional data using multiple informants (adolescents, peers, and parents) and multiple methods (performance test and self-report). Adolescent social orientation, as reflected in perceived problem solving effectiveness, identification with adult prosocial values, and self-efficacy expectations, exhibited a direct association to delinquent behavior and an indirect association to drug involvement mediated by demonstrated success in using problem solving skills. Results suggest that the utility of social skill theories of adolescent problem behaviors for informing preventive and remedial interventions can be enhanced by expanding them to consider adolescents’ orientation toward using the skills they may already possess. PMID:16929380

Fixed Orientation Interconnection Problems: Theory, Algorithms and Applications

DEFF Research Database (Denmark)

Zachariasen, Martin

Interconnection problems have natural applications in the design of integrated circuits (or chips). A modern chip consists of billions of transistors that are connected by metal wires on the surface of the chip. These metal wires are routed on a (fairly small) number of layers in such a way...... that electrically independent nets do not intersect each other. Traditional manufacturing technology limits the orientations of the wires to be either horizontal or vertical — and is known as Manhattan architecture. Over the last decade there has been a growing interest in general architectures, where more than two...... a significant step forward, both concerning theory and algorithms, for the fixed orientation Steiner tree problem. In addition, the work maintains a close link to applications and generalizations motivated by chip design....

Arch-pattern based design and aspect-oriented implementation of Readers-Writers concurrent problem

Directory of Open Access Journals (Sweden)

Dumitru Ciorbă

2007-11-01

Full Text Available The classical problems of concurrent programming start from the design problems of operating systems in the 80-s. But today there are still proposed new solutions for these problems with the help of various design and programming approaches. The present article describes a solution which was designed according to some new object-oriented principles, based on design patterns and proposes two program solutions: firstly - an object-oriented implementation in Java language, the secondly – an aspect-oriented one in AspectJ language.

Development of the electronic patient record system based on problem oriented system.

Science.gov (United States)

Uto, Yumiko; Iwaanakuchi, Takashi; Muranaga, Fuminori; Kumamoto, Ichiro

2013-01-01

In Japan, POS (problem oriented system) is recommended in the clinical guideline. Therefore, the records are mainly made by SOAP. We developed a system mainly with a function which enabled our staff members of all kinds of professions including doctors to enter the patients' clinical information as an identical record, regardless if they were outpatients or inpatients, and to observe the contents chronologically. This electric patient record system is called "e-kanja recording system". On this system, all staff members in the medical team can now share the same information. Moreover, the contents can be reviewed by colleagues; the quality of records has been improved as it is evaluated by the others.

Analysis of the Status Quo of Humanistic Quality-Oriented Education in Medical Colleges and Universities

Science.gov (United States)

Liu, Shulei; Li, Yamin

2012-01-01

With transformation of contemporary modern medical educational modes and improvement of requirement upon doctors' humanistic quality, it seems quite important to strengthen humanistic quality-oriented education in medical colleges and universities. Medical humanistic quality-oriented education in China started late, which determines that there are…

Research on problem solving skills of orienteering athletes in terms of some variables

Directory of Open Access Journals (Sweden)

Eroğlu Başak

2016-01-01

Full Text Available The aim of this study is to examine the problem solving skills of orienteering athletes in terms of different variables. 157 male and 43 female orienteering athletes, making a total of 200 athletes that joined the 3rd Level of Turkey Championship in 2015 have participated in this study which is in a survey model. The data collection tools were the Problem Solving Inventory and Personal Information Form that were formed by Heppner & Peterson (1982 and adapted into Turkish by Şahin, Şahin & Heppner (1993. In the data analysis, descriptive statics, anova, t test and Tukey test have been utilized. In the line with the findings, it has been determined that the difference between the total mean values (85.55+20.45 that the orienteering athletes got from the problem solving inventory and their age, marital status, sports age, the years of practice in orienteering sports, and the status of being national player is significant (p<0.05. It has been found that male orienteering athletes perform higher evaluating approach compared to the female athletes, and that as the age levels increase, the problem solving skill is affected more positively. Furthermore, it has been determined that the perceptions of the participants that have more experience and sports age in orienteering sports and that do orienteering sports at a national level are more positive in the matter of problem solving skills.

The split delivery capacitated team orienteering problem

NARCIS (Netherlands)

Archetti, C.; Bianchessi, N.; Speranza, M. G.; Hertz, A.

2014-01-01

In this article, we study the capacitated team orienteering problem where split deliveries are allowed. A set of potential customers is given, each associated with a demand and a profit. The set of customers to be served by a fleet of capacitated vehicles has to be identified in such a way that the

Examining Sexual Orientation Disparities in Unmet Medical Needs among Men and Women

OpenAIRE

Everett, Bethany G.; Mollborn, Stefanie

2013-01-01

Using the National Longitudinal Study of Adolescent Health (N = 13,810), this study examines disparities in unmet medical needs by sexual orientation identity during young adulthood. We use binary logistic regression and expand Andersen’s health care utilization framework to identify factors that shape disparities in unmet medical needs by sexual orientation. We also investigate whether the well-established gender disparity in health-seeking behaviors among heterosexual persons holds for sexu...

The accountability problem of flooding attacks in service-oriented architectures

DEFF Research Database (Denmark)

Jensen, Meiko; Schwenk, Jörg

2009-01-01

The threat of Denial of Service attacks poses a serious problem to the security of network-based services in general. For flooding attacks against service-oriented applications, this threat is dramatically amplified with potentially much higher impact and very little effort on the attacker's side....... Additionally, due to the high distribution of a SOA application's components, fending such attacks becomes a far more complex task. In this paper, we present the problem of accountability, referring to the issue of resolving the attacker in a highly distributed service-oriented application. Using a general...

Lessons learned from implementation of a computerized application for pending tests at hospital discharge.

Science.gov (United States)

Dalal, Anuj K; Poon, Eric G; Karson, Andrew S; Gandhi, Tejal K; Roy, Christopher L

2011-01-01

Patients are often discharged from the hospital before test results are finalized. Awareness of these results is poor and therefore an important patient safety concern. Few computerized systems have been deployed at care transitions to address this problem. We describe an attempt to implement a computerized application to help inpatient physicians manage these test results. We modified an ambulatory electronic medical record (EMR)-based results management application to track pending tests at hospital discharge (Hospitalist Results Manager, HRM). We trained inpatient physicians at 2 academic medical centers to track these tests using this application. We surveyed inpatient physicians regarding usage of and satisfaction with the application, barriers to use, and the characteristics of an ideal system to track pending tests at discharge. Of 29 survey respondents, 14 (48%) reported never using HRM, and 13 (45%) used it 1 to 2 times per week. A total of 23 (79%) reported barriers prohibiting use, including being inundated with clinically "irrelevant" results, not having sufficient time, and a lack of integration of post-discharge test result management into usual workflow. Twenty-one (72%) wanted to receive notification of abnormal and clinician-designated pending test results. Twenty-seven physicians (93%) agreed that an ideally designed computerized application would be valuable for managing pending tests at discharge. Although inpatient physicians would highly value a computerized application to manage pending tests at discharge, the characteristics of an ideal system are unclear and there are important barriers prohibiting adoption and optimal usage of such systems. We outline suggestions for future electronic systems to manage pending tests at discharge. Copyright © 2010 Society of Hospital Medicine.

Orienting to Medicine: Scripting Professionalism, Hierarchy, and Social Difference at the Start of Medical School.

Science.gov (United States)

Craig, Sienna R; Scott, Rebekah; Blackwood, Kristy

2018-04-23

Nascent medical students' first view into medical school orients them toward what is considered important in medicine. Based on ethnography conducted over 18 months at a New England medical school, this article explores themes which emerged during a first-year student orientation and examines how these scripts resurface across a four-year curriculum, revealing dynamics of enculturation into an institution and the broader profession. We analyze orientation activities as discursive and embodied fields which serve "practical" purposes of making new social geographies familiar, but which also frame institutional values surrounding "soft" aspects of medicine: professionalism; dynamics of hierarchy and vulnerability; and social difference. By examining orientation and connecting these insights to later, discerning educational moments, we argue that orientation reveals tensions between the overt and hidden curricula within medical education, including what being a good doctor means. Our findings are based on data from semi-structured interviews, focus groups, and participant-observation in didactic and clinical settings. This article answers calls within medical anthropology and medical education literature to recognize implicit values at play in producing physicians, unearthing ethnographically how these values are learned longitudinally via persisting gaps between formal and hidden curricula. Assumptions hidden in plain sight call for ongoing medical education reform.

ESARDA approach to facility oriented safeguards problems

International Nuclear Information System (INIS)

Stewart, R.

1979-01-01

The paper outlines the brief history of a Working Group composed of nuclear fuel plant operators, safeguards research workers and safeguards inspectors who are examining facility orientated problems of nuclear materials control and verification activities. The working program is reviewed together with some examples of various problems and the way the group is collaborating to develop solutions by pooling resources and effort. Work in European low enriched uranium fabrication plants from UF 6 to finished fuel is discussed in connection with mesurement practices, real time accounting, error propagation and analysis, verification and surveillance

Conversion from intravenous to oral medications: assessment of a computerized intervention for hospitalized patients.

Science.gov (United States)

Fischer, Michael A; Solomon, Daniel H; Teich, Jonathan M; Avorn, Jerry

2003-11-24

Many hospitalized patients continue to receive intravenous medications longer than necessary. Earlier conversion from the intravenous to the oral route could increase patient safety and comfort, reduce costs, and facilitate earlier discharge from the hospital without compromising clinical care. We examined the effect of a computer-based intervention to prompt physicians to switch appropriate patients from intravenous to oral medications. This study was performed at Brigham and Women's Hospital, an academic tertiary care hospital at which all medications are ordered online. We targeted 5 medications with equal oral and intravenous bioavailability: fluconazole, levofloxacin, metronidazole, ranitidine, and amiodarone. We used the hospital's computerized order entry system to prompt physicians to convert appropriate intravenous medications to the oral route. We measured the total use of the targeted medications via each route in the 4 months before and after the implementation of the intervention. We also measured the rate at which physicians responded to the intervention when prompted. The average intravenous defined daily dose declined by 11.1% (P =.002) from the preintervention to the postintervention period, while the average oral defined daily dose increased by 3.7% (P =.002). Length of stay, case-mix index, and total drug use at the hospital increased during the study period. The average total monthly use of the intravenous preparation of all of the targeted medications declined in the 4 months after the intervention began, compared with the 4 months before. In 35.6% of 1045 orders for which a prompt was generated, the physician either made a conversion from the intravenous to the oral version or canceled the order altogether. Computer-generated reminders can produce a substantial reduction in excessive use of targeted intravenous medications. As online prescribing becomes more common, this approach can be used to reduce excess use of intravenous medications

Library of problem-oriented programs for solving problems of atomic and nuclear physics

International Nuclear Information System (INIS)

Kharitonov, Yu.I.

1976-01-01

The Data Centre of the Leningrad Institute of Nuclear Physics (LIYaF) is working on the establishment of a library of problem-oriented computer programs for solving problems of atomic and nuclear physics. This paper lists and describes briefly the programs presently available to the Data Centre. The descriptions include the program code numbers, the program language, the translator for which the program is designed, and the program scope

Computerized tomography. Fundamentals, equipment, image quality, applications. 2. rev. and enl. ed.

International Nuclear Information System (INIS)

Kalender, W.A.

2006-01-01

The book provides a clear and user-oriented outline of the theoretical and technical fundamentals of computerized tomography for a wide range of readers, from conventional CT to volume CT with conical beams. Image quality, its relevant influencing parameters and the performance factors to be observed for clinical application are discussed in detail, as are dose requirements, dose metering and dose reduction measures in CT. The second, revised edition contains updated information and also presents new technologies. A CD-ROM with attractive exemplary appications, animations and interactive exercises in image interpretation and manipulation is included. The book addresses everyone concerned with CT, either in their daily routine or even only every now and then, i.e. physicians, medical assistants, engineers, technicians and physicists. The book also contains a glossary of technical terms. (orig.)

A Spiral And Discipline-Oriented Curriculum In Medical Imaging

DEFF Research Database (Denmark)

Wilhjelm, Jens E.; Hanson, Lars G.; Henneberg, Kaj-Åge

2011-01-01

This contribution describes and evaluates an experimental combination of a spiral and discipline-oriented curriculum implemented in the bachelor’s and master’s program in Medicine and Technology. The implementation in the master’s program is in the form of a study line in Medical Imaging and Radi......This contribution describes and evaluates an experimental combination of a spiral and discipline-oriented curriculum implemented in the bachelor’s and master’s program in Medicine and Technology. The implementation in the master’s program is in the form of a study line in Medical Imaging...... and Radiation Physics containing three disciplines: Imaging modalities, Radiation therapy and Image processing. The two imaging courses in the bachelor’s program and the first imaging course in the master’s program follow a spiral curriculum in which most disciplines are encountered in all courses......, but in a gradually more advanced manner. The remaining courses in the master’s program follow a discipline-oriented curriculum. From a practical point of view, the spiral course portfolio works well in an undergraduate environment, where the courses involved are to be taken by all students and in the order planned...

Human factor engineering analysis for computerized human machine interface design issues

International Nuclear Information System (INIS)

Wang Zhifang; Gu Pengfei; Zhang Jianbo

2010-01-01

The application of digital I and C technology in nuclear power plants is a significant improvement in terms of functional performances and flexibility, and it also poses a challenge to operation safety. Most of the new NPPs under construction are adopting advanced control room design which utilizes the computerized human machine interface (HMI) as the main operating means. Thus, it greatly changes the way the operators interact with the plant. This paper introduces the main challenges brought out by computerized technology on the human factor engineering aspect and addresses the main issues to be dealt with in the computerized HMI design process. Based on a operator task-resources-cognitive model, it states that the root cause of human errors is the mismatch between resources demand and their supply. And a task-oriented HMI design principle is discussed. (authors)

Survey of methods for improving operator acceptance of computerized aids

International Nuclear Information System (INIS)

Frey, P.R.; Kisner, R.A.

1982-04-01

The success of current attempts to improve the operational performance and safety of nuclear power plants by installing computerized operational aids in the control rooms is dependent, in part, on the operator's attitude toward the aid. Utility experience with process computer systems indicates that problems may already exist with operator acceptance of computerized aids. The growth of the role that computers have in nuclear power plants makes user acceptance of computer technology an important issue for the nuclear industry. The purpose of this report is to draw from the literature factors related to user acceptance of computerized equipment that may also be applicable to the acceptance of computerized aids used in the nuclear power plant control room

Survey of methods for improving operator acceptance of computerized aids

Energy Technology Data Exchange (ETDEWEB)

Frey, P. R.; Kisner, R. A.

1982-04-01

The success of current attempts to improve the operational performance and safety of nuclear power plants by installing computerized operational aids in the control rooms is dependent, in part, on the operator's attitude toward the aid. Utility experience with process computer systems indicates that problems may already exist with operator acceptance of computerized aids. The growth of the role that computers have in nuclear power plants makes user acceptance of computer technology an important issue for the nuclear industry. The purpose of this report is to draw from the literature factors related to user acceptance of computerized equipment that may also be applicable to the acceptance of computerized aids used in the nuclear power plant control room.

When you have to climb downhill to reach the top: the effect of action versus state orientation on solvinga goal-subgoal conflict in the Tower of Hanoi task.

Science.gov (United States)

Jostmann, Nils B; Gieselmann, Annika

2014-01-01

Complex problems often include a response conflict between a subgoal and a final goal. The present experiment investigated the roles of situational demands and individual differences in self-regulation on solving goal-subgoal conflicts in a computerized Tower of Hanoi task. Action-oriented versus state-oriented individuals were randomly assigned to a demanding condition in which they deliberated about a personal decision problem, or to a nondemanding control condition. In line with expectations state-oriented individuals had greater difficulties to solve goal-subgoal conflicts in the demanding compared to the nondemanding condition. Action-oriented individuals performed well in both conditions. In line with Personality Systems Interactions theory (Kuhl, 2000) the findings show that complex problem solving depends on how well people are able to deal with situational demands.

The capacitated team orienteering problem with incomplete service

NARCIS (Netherlands)

Archetti, Claudia; Bianchessi, Nicola; Speranza, M. Grazia

2013-01-01

In this paper we study the capacitated version of the Team Orienteering Problem (TOP), that is the Capacitated TOP (CTOP) and the impact of relaxing the assumption that a customer, if served, must be completely served. We prove that the profit collected by the CTOP with Incomplete Service (CTOP-IS)

Dealing with Insecurity in Problem Oriented Learning Approaches--The Importance of Problem Formulation

Science.gov (United States)

Jensen, Annie Aarup; Lund, Birthe

2016-01-01

Introduction of a pedagogical concept, Kubus, in a problem oriented learning context--analysed within the framework of an activity system--indicates what might happen when offering tools tempting to influence and regulate students' learning approach and hereby neglecting the importance of existing habits and values. Introduction of this new…

Computerized Italian criticality guide, description and validation

International Nuclear Information System (INIS)

Carotenuto, M.; Landeyro, P.A.

1988-10-01

Our group is developing an 'expert system' for collecting engineering know-how on back-end nuclear plant design. An expert system is the most suitable software tool for our problem. During the analysis, the design process was divided into different branches. At each branch of the design process the Expert System relates a computerized design procedure. Any design procedure is composed of a set of design methods, together with their condition of application and reliability limits. In the framework of this expert system, the nuclear criticality safety analysis procedure was developed, in the form of a computerized criticality guide, attempting to reproduce the designer's normal 'reasoning' process. The criticality guide is composed of two parts: A computerized text, including theory, a description of the accidents occurred in the past and a description of the italian design experience; An interactive computer aided calculation module, containing a graphical facility for critical parameter curves. In the present report are presented the criticality guide (computerized Italian Criticality Guide) and its validation test. (author)

Computerized Italian criticality guide, description and validation

Energy Technology Data Exchange (ETDEWEB)

Carotenuto, M; Landeyro, P A [ENEA - Dipartimento Ciclo del Combustibile, Centro Ricerche Energia, Casaccia (Italy)

1988-10-15

Our group is developing an 'expert system' for collecting engineering know-how on back-end nuclear plant design. An expert system is the most suitable software tool for our problem. During the analysis, the design process was divided into different branches. At each branch of the design process the Expert System relates a computerized design procedure. Any design procedure is composed of a set of design methods, together with their condition of application and reliability limits. In the framework of this expert system, the nuclear criticality safety analysis procedure was developed, in the form of a computerized criticality guide, attempting to reproduce the designer's normal 'reasoning' process. The criticality guide is composed of two parts: A computerized text, including theory, a description of the accidents occurred in the past and a description of the italian design experience; An interactive computer aided calculation module, containing a graphical facility for critical parameter curves. In the present report are presented the criticality guide (computerized Italian Criticality Guide) and its validation test. (author)

The Impact of Computerization on Archival Finding Aids: A RAMP Study.

Science.gov (United States)

Kitching, Christopher

This report is based on a questionnaire sent to 32 selected National Archives and on interviews with archivists from eight countries. Geared to the needs of developing countries, the report covers: (1) the impact of computerization on finding aids; (2) advantages and problems of computerization, including enhanced archival control, integration of…

An inventory of publications on electronic medical records revisited.

Science.gov (United States)

Moorman, P W; Schuemie, M J; van der Lei, J

2009-01-01

In this short review we provide an update of our earlier inventories of publications indexed in MedLine with the MeSH term 'Medical Records Systems, Computerized'. We retrieved and analyzed all references to English articles published before January 1, 2008, and indexed in PubMed with the MeSH term 'Medical Records Systems, Computerized'. We retrieved a total of 11,924 publications, of which 3937 (33%) appeared in a journal with an impact factor. Since 2002 the number of yearly publications, and the number of journals in which those publications appeared, increased. A cluster analysis revealed three clusters: an organizational issues cluster, a technically oriented cluster and a cluster about order-entry and research. Although our previous inventory in 2003 suggested a constant yearly production of publications on electronic medical records since 1998, the current inventory shows another rise in production since 2002. In addition, many new journals and countries have shown interest during the last five years. In the last 15 years, interest in organizational issues remained fairly constant, order entry and research with systems gained attention, while interest in technical issues relatively decreased.

When you have to climb downhill to reach the top: The effect of action versus state orientation on solving a goal-subgoal conflict in the Tower of Hanoi task

NARCIS (Netherlands)

Jostmann, N.B.; Gieselmann, A.

2014-01-01

Complex problems often include a response conflict between a subgoal and a final goal. The present experiment investigated the roles of situational demands and individual differences in self-regulation on solving goal-subgoal conflicts in a computerized Tower of Hanoi task. Action-oriented versus

Correlations between the scores of computerized adaptive testing, paper and pencil tests, and the Korean Medical Licensing Examination

Directory of Open Access Journals (Sweden)

Mee Young Kim

2005-06-01

Full Text Available To evaluate the usefulness of computerized adaptive testing (CAT in medical school, the General Examination for senior medical students was administered as a paper and pencil test (P&P and using CAT. The General Examination is a graduate examination, which is also a preliminary examination for the Korean Medical Licensing Examination (KMLE. The correlations between the results of the CAT and P&P and KMLE were analyzed. The correlation between the CAT and P&P was 0.8013 (p=0.000; that between the CAT and P&P was 0.7861 (p=0.000; and that between the CAT and KMLE was 0.6436 (p=0.000. Six out of 12 students with an ability estimate below 0.52 failed the KMLE. The results showed that CAT could replace P&P in medical school. The ability of CAT to predict whether students would pass the KMLE was 0.5 when the criterion of the theta value was set at -0.52 that was chosen arbitrarily for the prediction of pass or failure.

The Orienteering Problem under Uncertainty Stochastic Programming and Robust Optimization compared

NARCIS (Netherlands)

L. Evers (Lanah); K.M. Glorie (Kristiaan); S. van der Ster (Suzanne); A.I. Barros (Ana); H. Monsuur (Herman)

2012-01-01

textabstractThe Orienteering Problem (OP) is a generalization of the well-known traveling salesman problem and has many interesting applications in logistics, tourism and defense. To reflect real-life situations, we focus on an uncertain variant of the OP. Two main approaches that deal with

The Orienteering Problem under Uncertainty Stochastic Programming and Robust Optimization compared

NARCIS (Netherlands)

Evers, L.; Glorie, K.; Ster, S. van der; Barros, A.I.; Monsuur, H.

2012-01-01

The Orienteering Problem (OP) is a generalization of the well-known traveling salesman problem and has many interesting applications in logistics, tourism and defense. To reflect real-life situations, we focus on an uncertain variant of the OP. Two main approaches that deal with optimization under

The computerized patient record: Where do we stand?

NARCIS (Netherlands)

Jaspers, M. W. M.; Knaup, P.; Schmidt, D.

2006-01-01

OBJECTIVES: To provide an overview of trends in research, developments and implementations of the computerized patient record (CPR) of the last two years. METHODS: We surveyed the medical informatics literature, spanning the years 2004-2005, focusing on publications on CPRs. RESULTS: The main trends

The study on the perceptions of radiological technologist in medical imaging equipment used by the oriental doctor

International Nuclear Information System (INIS)

Choi, Jae Ho; Kang, Gi Bong; Kim, Sang Hyun

2017-01-01

In order to examine how Radiological Technologists perceive the oriental doctor's use of Medical Imaging Equipment, surveys were conducted for the members of the Korean Radiological Technologists Association. The total number of respondents were 515 and 481, with 34 insincere responses removed caused of nonvalidated answer. The results of the analysis are as follows. Although there were no statistical significance in the difference in perception by location of residence, work place, and educational background, respondents with higher education showed a tendency to agree on the use of comprehensive medical imaging equipment, but tended to oppose the use of special medical imaging equipment. Differences in perception by gender showed a greater negative perception toward the oriental doctor's use of medical imaging equipment by women than men. In particular, women showed more negative tendency for oriental doctor's use of special medical imaging equipment such as MRI, CT, and ultrasound equipment compared to men, and this was statistically significant. The difference in perception by age showed that the oriental doctor's use of medical imaging equipment was negative in the 20∼30s, neutral in the 40∼50s, and positive in the 60s, which were statistically significant. The difference in perception by work experience showed that the longer the work experience was, the more positive it was toward oriental doctor's use of medical imaging equipment. Specifically, the most favorable tendency was found with work experience of more than 30 years, which was statistically significant. The results of this study revealed the Radiological Technologists' perceptions on the oriental doctor's use of Medical Imaging Equipment and this can contribute to the direction of public health promotion in the future

Enhancing Problem-Solving Capabilities Using Object-Oriented Programming Language

Science.gov (United States)

Unuakhalu, Mike F.

2009-01-01

This study integrated object-oriented programming instruction with transfer training activities in everyday tasks, which might provide a mechanism that can be used for efficient problem solving. Specifically, a Visual BASIC embedded with everyday tasks group was compared to another group exposed to Visual BASIC instruction only. Subjects were 40…

Impact of Sexual Orientation Identity on Medical Morbidities in Male-to-Female Transgender Patients.

Science.gov (United States)

Gaither, Thomas W; Awad, Mohannad A; Osterberg, E Charles; Romero, Angelita; Bowers, Marci L; Breyer, Benjamin N

2017-02-01

We aim to describe the relationship between sexual orientation identity and medical morbidities in a large sample of male-to-female (MTF) transgender patients. We reviewed medical records of patients presenting for MTF sex reassignment surgery (SRS) by a single, high-volume surgeon from 2011 to 2015. Sexual attraction to men (heterosexual), women (lesbian), or both (bisexual) was asked of each patient. We examined 16 medical morbidities for this analysis. During the study period, 330 MTF transgender patients presented for SRS. The average age at the time of surgery was 38.9 (range 18-76). One hundred and one patients (32%) reported being heterosexual, 110 patients (34%) reported being lesbian, and 108 patients (34%) reported being bisexual. Lesbian patients presented for SRS at older ages (mean = 43 years old) compared with heterosexual patients (mean = 36 years old) and bisexual patients (mean = 37), P sexual orientation identity. Lesbian patients had greater odds of having a history of depression, age-adjusted odds ratio (aOR) = 2.36, 95% confidence interval (CI) 1.26-4.40, compared with heterosexual patients. Lesbian patients had higher odds of being married or partnered, aOR = 2.31, 95% CI (1.27-4.19), compared with heterosexual patients. Heterosexual patients had higher odds of having human immunodeficiency virus (HIV), aOR = 9.07, 95% CI (1.08-76.5) compared with lesbian patients. Sexual orientation identity in MTF transgender patients is variable. The majority of medical morbidities are not associated with sexual orientation identity. Although HIV and depression are common morbidities among MTF patients seeking SRS, the prevalence of these morbidities differs by sexual orientation identity, but these findings need replication. Counseling and future research initiatives in transgender care should incorporate sexual orientation identity and associated risk behavior.

The study on the perceptions of radiological technologist in medical imaging equipment used by the oriental doctor

Energy Technology Data Exchange (ETDEWEB)

Choi, Jae Ho [Dept. of Radiological Technology, Ansan University, Ansan (Korea, Republic of); Kang, Gi Bong [Dept. of Radiology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Sang Hyun [Dept. of Radiology, Shinhan University, Seongnam (Korea, Republic of); and others

2017-03-15

In order to examine how Radiological Technologists perceive the oriental doctor's use of Medical Imaging Equipment, surveys were conducted for the members of the Korean Radiological Technologists Association. The total number of respondents were 515 and 481, with 34 insincere responses removed caused of nonvalidated answer. The results of the analysis are as follows. Although there were no statistical significance in the difference in perception by location of residence, work place, and educational background, respondents with higher education showed a tendency to agree on the use of comprehensive medical imaging equipment, but tended to oppose the use of special medical imaging equipment. Differences in perception by gender showed a greater negative perception toward the oriental doctor's use of medical imaging equipment by women than men. In particular, women showed more negative tendency for oriental doctor's use of special medical imaging equipment such as MRI, CT, and ultrasound equipment compared to men, and this was statistically significant. The difference in perception by age showed that the oriental doctor's use of medical imaging equipment was negative in the 20∼30s, neutral in the 40∼50s, and positive in the 60s, which were statistically significant. The difference in perception by work experience showed that the longer the work experience was, the more positive it was toward oriental doctor's use of medical imaging equipment. Specifically, the most favorable tendency was found with work experience of more than 30 years, which was statistically significant. The results of this study revealed the Radiological Technologists' perceptions on the oriental doctor's use of Medical Imaging Equipment and this can contribute to the direction of public health promotion in the future.

A Two-Stage Approach to the Orienteering Problem with Stochastic Weights

NARCIS (Netherlands)

Evers, L.; Glorie, K.; Ster, S. van der; Barros, A.I.; Monsuur, H.

2014-01-01

The Orienteering Problem (OP) is a routing problem which has many interesting applications in logistics, tourism and defense. The aim of the OP is to find a maximum profit path or tour, which is feasible with respect to a capacity constraint on the total weight of the selected arcs. In this paper we

A two-stage approach to the orienteering problem with stochastic weights

NARCIS (Netherlands)

Evers, L.; Glorie, K.M.; van der Ster, S.L.; Barros, A.I.; Monsuur, H.

2014-01-01

The Orienteering Problem (OP) is a routing problem which has many interesting applications in logistics, tourism and defense. The aim of the OP is to find a maximum profit path or tour, which is feasible with respect to a capacity constraint on the total weight of the selected arcs. In this paper we

APPLYING PROFESSIONALLY ORIENTED PROBLEMS OF MATHEMATICAL MODELING IN TEACHING STUDENTS OF ENGINEERING DEPARTMENTS

Directory of Open Access Journals (Sweden)

Natal’ya Yur’evna Gorbunova

2017-06-01

Full Text Available We described several aspects of organizing student research work, as well as solving a number of mathematical modeling problems: professionally-oriented, multi-stage, etc. We underlined the importance of their economic content. Samples of using such problems in teaching Mathematics at agricultural university were given. Several questions connected with information material selection and peculiarities of research problems application were described. Purpose. The author aims to show the possibility and necessity of using professionally-oriented problems of mathematical modeling in teaching Mathematics at agricultural university. The subject of analysis is including such problems into educational process. Methodology. The main research method is dialectical method of obtaining knowledge of finding approaches to selection, writing and using mathematical modeling and professionally-oriented problems in educational process; the methodology is study of these methods of obtaining knowledge. Results. As a result of analysis of literature, students opinions, observation of students work, and taking into account personal teaching experience, it is possible to make conclusion about importance of using mathematical modeling problems, as it helps to systemize theoretical knowledge, apply it to practice, raise students study motivation in engineering sphere. Practical implications. Results of the research can be of interest for teachers of Mathematics in preparing Bachelor and Master students of engineering departments of agricultural university both for theoretical research and for modernization of study courses.

MEDICAL DIAGNOSTICS BY MICROSTRUCTURAL ANALYSIS OF BIOLOGICAL LIQUID DRIED PATTERNS AS A PROBLEM OF BIOINFORMATICS

Directory of Open Access Journals (Sweden)

Petr Vladimirovich Lebedev-Stepanov, Dr.

2018-02-01

Full Text Available Motivation: It is important to develop the high-precision computerized methods for medical rapid diagnostic which is generalizing the unique clinical experience obtained in the past decade as specialized solutions for diagnostic problems of control of specific diseases and, potentially, for a wide health monitoring of virtually healthy population, identify the reserves of human health and take the actions to prevent of these reserves depletion. In this work we present one of the new directions in bioinformatics, i.e. medical diagnostics by automated expert system on basis of morphology analysis of digital image of biological liquid dried pattern. Results: Proposed method is combination of bioinformatics and biochemistry approaches for obtaining diagnostic information from a morphological analysis of standardized dried patterns of biological liquid sessile drop. We have carried out own research in collaboration with medical diagnostic centers and formed the electronic database for recognition the following types of diseases: candidiasis; neoplasms; diabetes mellitus; diseases of the circulatory system; cerebrovascular disease; diseases of the digestive system; diseases of the genitourinary system; infectious diseases; factors relevant to the work; factors associated with environmental pollution; factors related to lifestyle. The laboratory setup for diagnostics of the human body in pathology states is developed. The diagnostic results are considered. Availability: Access to testing the software can be obtained on request to the contact email below.

Object-oriented design and programming in medical decision support.

Science.gov (United States)

Heathfield, H; Armstrong, J; Kirkham, N

1991-12-01

The concept of object-oriented design and programming has recently received a great deal of attention from the software engineering community. This paper highlights the realisable benefits of using the object-oriented approach in the design and development of clinical decision support systems. These systems seek to build a computational model of some problem domain and therefore tend to be exploratory in nature. Conventional procedural design techniques do not support either the process of model building or rapid prototyping. The central concepts of the object-oriented paradigm are introduced, namely encapsulation, inheritance and polymorphism, and their use illustrated in a case study, taken from the domain of breast histopathology. In particular, the dual roles of inheritance in object-oriented programming are examined, i.e., inheritance as a conceptual modelling tool and inheritance as a code reuse mechanism. It is argued that the use of the former is not entirely intuitive and may be difficult to incorporate into the design process. However, inheritance as a means of optimising code reuse offers substantial technical benefits.

Statistical problems in medical research

African Journals Online (AJOL)

STORAGESEVER

2008-12-29

Dec 29, 2008 ... medical research, there are some common problems in using statistical methodology which may result ... optimal combination of diagnostic tests for osteoporosis .... randomization used include stratification and minimize-.

Pocket book on setting techniques for medical imaging. X-ray diagnostics, angiography, CT, MRT. 4. rev. and enl. ed.; Taschenatlas Einstelltechnik. Roentgendiagnostik, Angiografie, CT, MRT

Energy Technology Data Exchange (ETDEWEB)

Moeller, Torsten B.; Reif, Emil [Caritas-Krankenhaus, Dillingen/Saar (Germany)

2009-07-01

The pocketbook on setting techniques for medical imaging is concerned with the problem to prepare appropriate images for diagnostic purposes using modern high-technology instruments like x-ray diagnostics, angiography, computerized tomography and magnetic resonance tomography. The following issues are covered: Head, spinal column, upper extremities, lower extremities, thorax, gastrointestinal tract, intravenous organ examination, angiography, computerized tomography, NMR imaging.

Enabling Effective Problem-oriented Research for Sustainable Development

Directory of Open Access Journals (Sweden)

Christoph Kueffer

2012-12-01

Full Text Available Environmental problems caused by human activities are increasing; biodiversity is disappearing at an unprecedented rate, soils are being irreversibly damaged, freshwater is increasingly in short supply, and the climate is changing. To reverse or even to reduce these trends will require a radical transformation in the relationship between humans and the natural environment. Just how this can be achieved within, at most, a few decades is unknown, but it is clear that academia must play a crucial role. Many believe, however, that academic institutions need to become more effective in helping societies move toward sustainability. We first synthesize current thinking about this crisis of research effectiveness. We argue that those involved in producing knowledge to solve societal problems face three particular challenges: the complexity of real-world sustainability problems, maintaining impartiality when expert knowledge is used in decision making, and ensuring the salience of the scientific knowledge for decision makers. We discuss three strategies to meet these challenges: conducting research in interdisciplinary teams, forming research partnerships with actors and experts from outside academia, and framing research questions with the aim of solving specific problems (problem orientation. However, we argue that implementing these strategies within academia will require both cultural and institutional change. We then use concepts from transition management to suggest how academic institutions can make the necessary changes. At the level of system optimization, we call for: quality criteria, career incentives, and funding schemes that reward not only disciplinary excellence but also achievements in inter-/transdisciplinary work; professional services and training through specialized centers that facilitate problem-oriented research and reciprocal knowledge exchange with society; and the integration of sustainability and inter

Antipsychotic treatment in schizophrenia: the role of computerized neuropsychological assessment.

Science.gov (United States)

Kertzman, Semion; Reznik, Ilya; Grinspan, Haim; Weizman, Abraham; Kotler, Moshe

2008-01-01

The present study analyzes the role of neurocognitive assessment instruments in the detection of the contribution of antipsychotic treatment to cognitive functioning. Recently, a panel of experts suggested six main domains (working memory; attention/vigilance; verbal/visual learning and memory; reasoning and problem solving; speed of processing) implicated in schizophrenia-related cognitive deficits, which serve as a theoretical base for creation of real-time computerized neurocognitive batteries. The high sensitivity of computerized neuropsychological testing is based on their ability to adopt the reaction time (RT) paradigm for the assessment of brain function in a real-time regime. This testing is highly relevant for the monitoring of the cognitive effects of antipsychotics. Computerized assessment assists in the identification of state- and trait-related cognitive impairments. The optimal real-time computerized neurocognitive battery should composite balance between broad and narrow coverage of cognitive domains relevant to the beneficial effects of antipsychotics and will enable better planning of treatment and rehabilitation programs.

Student performance and their perception of a patient-oriented problem-solving approach with audiovisual aids in teaching pathology: a comparison with traditional lectures

OpenAIRE

Singh, Arjun

2010-01-01

Arjun SinghDepartment of Pathology, Sri Venkateshwara Medical College Hospital and Research Centre, Pondicherry, IndiaPurpose: We use different methods to train our undergraduates. The patient-oriented problem-solving (POPS) system is an innovative teaching–learning method that imparts knowledge, enhances intrinsic motivation, promotes self learning, encourages clinical reasoning, and develops long-lasting memory. The aim of this study was to develop POPS in teaching pathology, asse...

A branch-and-cut algorithm for the Team Orienteering Problem

NARCIS (Netherlands)

Bianchessi, Nicola; Mansini, Renata; Speranza, M. Grazia

2018-01-01

The Team Orienteering Problem aims at maximizing the total amount of profit collected by a fleet of vehicles while not exceeding a predefined travel time limit on each vehicle. In the last years, several exact methods based on different mathematical formulations were proposed. In this paper, we

Impact of Multidetector Computerized Tomography (MDCT) On The General Population

Energy Technology Data Exchange (ETDEWEB)

Leite, B.B.; Ribeiro, N.C. [Servico de Radiologia, Hospital de Curry Cabral, Rua da Beneficencia, 8, 1069-166 Lisboa (Portugal)

2009-05-15

Multidetector computerized tomography (MDCT) appeared in the early 1990s, as a technological evolution of computerized tomography. As one would expect, the evolution continues and, each year, more powerful equipments appear, with new medical applications. However, the general use of this technique has lead to the dramatic increase on the general population irradiation. Special concern is required regarding the most vulnerable groups, like the pediatric population, the pregnant and the young female. Due to a larger awareness of this irradiation risks, some initiatives have been developed, coming from different areas, aiming to maximize the benefit to risk ratio of MDCT. (author)

Disease Profiling for Computerized Peer Support of Ménière's Disease.

Science.gov (United States)

Rasku, Jyrki; Pyykkö, Ilmari; Levo, Hilla; Kentala, Erna; Manchaiah, Vinaya

2015-09-03

Peer support is an emerging form of person-driven active health care. Chronic conditions such as Ménière's disease (a disorder of the inner ear) need continuing rehabilitation and support that is beyond the scope of routine clinical medical practice. Hence, peer-support programs can be helpful in supplementing some of the rehabilitation aspects. The aim of this study was to design a computerized data collection system for the peer support of Menière's disease that is capable in profiling the subject for diagnosis and in assisting with problem solving. The expert program comprises several data entries focusing on symptoms, activity limitations, participation restrictions, quality of life, attitude and personality trait, and an evaluation of disease-specific impact. Data was collected from 740 members of the Finnish Ménière's Federation and utilized in the construction and evaluation of the program. The program verifies the diagnosis of a person by using an expert system, and the inference engine selects 50 cases with matched symptom severity by using a nearest neighbor algorithm. These cases are then used as a reference group to compare with the person's attitude, sense of coherence, and anxiety. The program provides feedback for the person and uses this information to guide the person through the problem-solving process. This computer-based peer-support program is the first example of an advanced computer-oriented approach using artificial intelligence, both in the profiling of the disease and in profiling the person's complaints for hearing loss, tinnitus, and vertigo. ©Jyrki Rasku, Ilmari Pyykkö, Hilla Levo, Erna Kentala, Vinaya Manchaiah. Originally published in JMIR Rehabilitation and Assistive Technology (http://rehab.jmir.org), 03.09.2015.

Drug-related problems identified in medication reviews by Australian pharmacists

DEFF Research Database (Denmark)

Stafford, Andrew C; Tenni, Peter C; Peterson, Gregory M

2009-01-01

OBJECTIVE: In Australia, accredited pharmacists perform medication reviews for patients to identify and resolve drug-related problems. We analysed the drug-related problems identified in reviews for both home-dwelling and residential care-facility patients. The objective of this study was to exam......OBJECTIVE: In Australia, accredited pharmacists perform medication reviews for patients to identify and resolve drug-related problems. We analysed the drug-related problems identified in reviews for both home-dwelling and residential care-facility patients. The objective of this study....... These reviews had been self-selected by pharmacists and submitted as part of the reaccreditation process to the primary body responsible for accrediting Australian pharmacists to perform medication reviews. The drug-related problems identified in each review were classified by type and drugs involved. MAIN...... OUTCOME MEASURE: The number and nature of drug-related problems identified in pharmacist-conducted medication reviews. RESULTS: There were 1,038 drug-related problems identified in 234 medication reviews (mean 4.6 (+/-2.2) problems per review). The number of problems was higher (4.9 +/- 2.0 vs. 3.9 +/- 2...

Alcohol Demand, Future Orientation, and Craving Mediate the Relation Between Depressive and Stress Symptoms and Alcohol Problems.

Science.gov (United States)

Soltis, Kathryn E; McDevitt-Murphy, Meghan E; Murphy, James G

2017-06-01

Elevated depression and stress have been linked to greater levels of alcohol problems among young adults even after taking into account drinking level. This study attempts to elucidate variables that might mediate the relation between symptoms of depression and stress and alcohol problems, including alcohol demand, future time orientation, and craving. Participants were 393 undergraduates (60.8% female, 78.9% White/Caucasian) who reported at least 2 binge-drinking episodes (4/5+ drinks for women/men, respectively) in the previous month. Participants completed self-report measures of stress and depression, alcohol demand, future time orientation, craving, and alcohol problems. In separate mediation models that accounted for gender, race, and weekly alcohol consumption, future orientation and craving significantly mediated the relation between depressive symptoms and alcohol problems. Alcohol demand, future orientation, and craving significantly mediated the relation between stress symptoms and alcohol problems. Heavy-drinking young adults who experience stress or depression are likely to experience alcohol problems, and this is due in part to elevations in craving and alcohol demand, and less sensitivity to future outcomes. Interventions targeting alcohol misuse in young adults with elevated levels of depression and stress should attempt to increase future orientation and decrease craving and alcohol reward value. Copyright © 2017 by the Research Society on Alcoholism.

Computerized adaptive testing item selection in computerized adaptive learning systems

NARCIS (Netherlands)

Eggen, Theodorus Johannes Hendrikus Maria; Eggen, T.J.H.M.; Veldkamp, B.P.

2012-01-01

Item selection methods traditionally developed for computerized adaptive testing (CAT) are explored for their usefulness in item-based computerized adaptive learning (CAL) systems. While in CAT Fisher information-based selection is optimal, for recovering learning populations in CAL systems item

Statistical Problems In Medical Research | Okeh | East African ...

African Journals Online (AJOL)

Given the main role of a general practitioner as a biostatistician, I thought it would be of interest to enumerate statistical problems in assessing methods of medical diagnosis in general terms. In conducting and reporting of medical research, there are some common problems in using statistical methodology which may result ...

Problems and Expectations of University Students Attending Higher Education in Turkey: Orientation Services

Science.gov (United States)

Kutlu, Mustafa

2005-01-01

The objective of this research is to find out the problems and expectations of the students in Inonu University (in Malatya, a city in east Turkey) concerning the orientation services. An additional objective is to ascertain whether students' expectations with regard to orientation services differ according to their sex, their place of origin, and…

Therminological problems in medical thermography

International Nuclear Information System (INIS)

Rozenfel'd, L.G.; Kolotilov, N.N.

1988-01-01

Some problems of medicotechnical terminology of clinical thermography are discussed. A short hystorical review of stages of the recovery of infrared rays and their medical application was given. An analysis of a number of terms is based on the rules of medical terminology and state standards. An obligatory use in literature of correct terms, mainly of the Greek and Latin origin, is proposed. Commonly used terms on the basis of modern anatomical terminology are recommended for thermogram description

Therminological problems in medical thermography

Energy Technology Data Exchange (ETDEWEB)

Rozenfel' d, L G; Kolotilov, N N

1988-01-01

Some problems of medicotechnical terminology of clinical thermography are discussed. A short hystorical review of stages of the recovery of infrared rays and their medical application was given. An analysis of a number of terms is based on the rules of medical terminology and state standards. An obligatory use in literature of correct terms, mainly of the Greek and Latin origin, is proposed. Commonly used terms on the basis of modern anatomical terminology are recommended for thermogram description.

The context of ethical problems in medical volunteer work.

Science.gov (United States)

Wall, Anji

2011-06-01

Ethical problems are common in clinical medicine, so medical volunteers who practice clinical medicine in developing countries should expect to encounter them just as they would in their practice in the developed world. However, as this article argues, medical volunteers in developing countries should not expect to encounter the same ethical problems as those that dominate Western biomedicine or to address ethical problems in the same way as they do in their practice in developed countries. For example, poor health and advanced disease increase the risks and decrease the potential benefits of some interventions. Consequently, when medical volunteers intervene too readily, without considering the nutritional and general health status of patients, the results can be devastating. Medical volunteers cannot assume that the outcomes of interventions in developing countries will be comparable to the outcomes of the same interventions in developed countries. Rather, they must realistically consider the complex medical conditions of patients when determining whether or not to intervene. Similarly, medical volunteers may face the question of whether to provide a pharmaceutical or perform an intervention that is below the acceptable standard of care versus the alternative of doing nothing. This article critically explores the contextual features of medical volunteer work in developing countries that differentiate it from medical practice in developed countries, arguing that this context contributes to the creation of unique ethical problems and affects the way in which these problems should be analyzed and resolved.

The influence of cultural and religious orientations on social support and its potential impact on medication adherence

Directory of Open Access Journals (Sweden)

Hatah E

2015-04-01

Full Text Available Ernieda Hatah,1 Kien Ping Lim,1,2 Adliah Mohd Ali,1 Noraida Mohamed Shah,1 Farida Islahudin1 1Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 2Pharmacy Department, Kuala Lumpur General Hospital, Jalan Pahang, Kuala Lumpur, Malaysia Purpose: Social support can positively influence patients’ health outcomes through a number of mechanisms, such as increases in patients’ adherence to medication. Although there have been studies on the influence of social support on medication adherence, these studies were conducted in Western settings, not in Asian settings where cultural and religious orientations may be different. The objective of this study was to assess the effects of cultural orientation and religiosity on social support and its relation to patients’ medication adherence. Methods: This was a cross-sectional study of patients with chronic diseases in two tertiary hospitals in Selangor, Malaysia. Patients who agreed to participate in the study were asked to answer questions in the following areas: 1 perceived group and higher authority cultural orientations; 2 religiosity: organizational and non-organizational religious activities, and intrinsic religiosity; 3 perceived social support; and 4 self-reported medication adherence. Patients’ medication adherence was modeled using multiple logistic regressions, and only variables with a P-value of <0.25 were included in the analysis. Results: A total of 300 patients completed the questionnaire, with the exception of 40 participants who did not complete the cultural orientation question. The mean age of the patients was 57.6±13.5. Group cultural orientation, organizational religious activity, non-organizational religious activity, and intrinsic religiosity demonstrated significant associations with patients’ perceived social support (r=0.181, P=0.003; r=0.230, P<0.001; r=0.135, P=0.019; and r=0.156, P=0.007, respectively. In the medication adherence model

Making The Most of Medical orientation; A New Approach.

Directory of Open Access Journals (Sweden)

Dr Jonathan Taitz

2004-02-01

Full Text Available Orientating new junior medical staff can be a complex and time consuming task. Traditional models have typically involved a day or longer of lectures. This involves a large number of senior staff being available on the first day of term. It also means that junior staff not present on the first day had any access to an orientation program at all. Evaluation of our program confirmed the belief that the day was dull and that there was simply too much information for new staff to absorb. As a result of this feedback we extensively updated our orientation program. Pre-reading of the junior staff manual became compulsory. We departed from the traditional lecture style program and devised a new ten- station scenario based interactive program. The stations were designed to cover aspects of the hospital’s mandatory education and key educational requirements in order to function effectively on our campus. Station leaders were selected and trained in the goals of the new process. Several of our secondment sites were engaged in the development of the project topics. We hoped that our secondment sites would be relieved of some orientation responsibility if core material was delivered centrally. The strength of the new orientation is that it is portable, reproducible and uniform. It is also available via video conferencing. A single person can educate new staff in three hours if the need arises. Most importantly all new staff will have access to the program within a week of starting a term at our hospital.

Self-Assessment of Problem Solving Disposition in Medical Students

Directory of Open Access Journals (Sweden)

Silvia Lizett Olivares-Olivares

2014-01-01

Full Text Available Medical schools are committed to both students and society to develop capabilities required to succeed in health care environments. Present diagnosis and treatment methods become obsolete faster, demanding that medical schools incorporate competency-based education to keep pace with future demands. This study was conducted to assess the problem solving disposition of medical students. A three-subcategory model of the skill is proposed. The instrument was validated on content by a group of 17 experts in medical education and applied to 135 registered students on the sixth year of the M.D. Physician Surgeon program at a private medical school. Cronbach’s alpha indicated an internal consistency of 0.751. The findings suggest that selected items have both homogeneity and validity. The factor analysis resulted in components that were associated with three problem-solving subcategories. The students’ perceptions are higher in the pattern recognition and application of general strategies for problem solving subcategories of the Problem solving disposition model.

Validation of the computerized annunciation message list system (CAMLS)

Energy Technology Data Exchange (ETDEWEB)

Feher, M P; Davey, E C; Lupton, L R [AECL, Chalk River Labs., Chalk River, ON (Canada)

1997-09-01

The Computerized Annunciation Message List System is a computerized annunciation system for the control rooms of nuclear generating stations. CAMLS will alert operators to changes in plant conditions that may impact on safety and production and help staff to effectively respond. CAMLS is designed to: provide a clear and concise overview of the current problems or faults in the plant; provide an overview of the current state of the plant in terms of automatic process and equipment actions; provide support for specific operational tasks, through either pre-configured or operator-configured annunciation displays, including: rapid and efficient upset response, plant stabilization, problem diagnosis, recovery action planning and implementation, and rapid recovery from trip and return to power operation. To achieve this, several information processing, presentation,a nd interaction concepts were developed. 2 refs, 6 figs, 7 tabs.

Validation of the computerized annunciation message list system (CAMLS)

International Nuclear Information System (INIS)

Feher, M.P.; Davey, E.C.; Lupton, L.R.

1997-01-01

The Computerized Annunciation Message List System is a computerized annunciation system for the control rooms of nuclear generating stations. CAMLS will alert operators to changes in plant conditions that may impact on safety and production and help staff to effectively respond. CAMLS is designed to: provide a clear and concise overview of the current problems or faults in the plant; provide an overview of the current state of the plant in terms of automatic process and equipment actions; provide support for specific operational tasks, through either pre-configured or operator-configured annunciation displays, including: rapid and efficient upset response, plant stabilization, problem diagnosis, recovery action planning and implementation, and rapid recovery from trip and return to power operation. To achieve this, several information processing, presentation,a nd interaction concepts were developed. 2 refs, 6 figs, 7 tabs

COMPRESS - a computerized reactor safety system

International Nuclear Information System (INIS)

Vegh, E.

1986-01-01

The computerized reactor safety system, called COMPRESS, provides the following services: scram initiation; safety interlockings; event recording. The paper describes the architecture of the system and deals with reliability problems. A self-testing unit checks permanently the correct operation of the independent decision units. Moreover the decision units are tested by short pulses whether they can initiate a scram. The self-testing is described in detail

10 years of computerized tomography reviewed

International Nuclear Information System (INIS)

Duemmling, K.

1984-01-01

The history and some highlights of computerized tomography are reviewed. The various technologies employed in the course of CT development are described along with the limitations that led to their disappearance. The problems still to be solved in medicine, the increasing influence of nuclear magnetic resonance, and some scientific aspects have opened up new lines of development which are briefly mentioned. (orig./WU) [de

Iterated local search algorithm for solving the orienteering problem with soft time windows.

Science.gov (United States)

Aghezzaf, Brahim; Fahim, Hassan El

2016-01-01

In this paper we study the orienteering problem with time windows (OPTW) and the impact of relaxing the time windows on the profit collected by the vehicle. The way of relaxing time windows adopted in the orienteering problem with soft time windows (OPSTW) that we study in this research is a late service relaxation that allows linearly penalized late services to customers. We solve this problem heuristically by considering a hybrid iterated local search. The results of the computational study show that the proposed approach is able to achieve promising solutions on the OPTW test instances available in the literature, one new best solution is found. On the newly generated test instances of the OPSTW, the results show that the profit collected by the OPSTW is better than the profit collected by the OPTW.

Simple solution to the medical instrumentation software problem

Science.gov (United States)

Leif, Robert C.; Leif, Suzanne B.; Leif, Stephanie H.; Bingue, E.

1995-04-01

Medical devices now include a substantial software component, which is both difficult and expensive to produce and maintain. Medical software must be developed according to `Good Manufacturing Practices', GMP. Good Manufacturing Practices as specified by the FDA and ISO requires the definition and compliance to a software processes which ensures quality products by specifying a detailed method of software construction. The software process should be based on accepted standards. US Department of Defense software standards and technology can both facilitate the development and improve the quality of medical systems. We describe the advantages of employing Mil-Std-498, Software Development and Documentation, and the Ada programming language. Ada provides the very broad range of functionalities, from embedded real-time to management information systems required by many medical devices. It also includes advanced facilities for object oriented programming and software engineering.

Future Orientation, School Contexts, and Problem Behaviors: A Multilevel Study

Science.gov (United States)

Chen, Pan; Vazsonyi, Alexander T.

2013-01-01

The association between future orientation and problem behaviors has received extensive empirical attention; however, previous work has not considered school contextual influences on this link. Using a sample of N = 9,163 9th to 12th graders (51.0% females) from N = 85 high schools of the National Longitudinal Study of Adolescent Health, the…

Problem-Oriented Corporate Knowledge Base Models on the Case-Based Reasoning Approach Basis

Science.gov (United States)

Gluhih, I. N.; Akhmadulin, R. K.

2017-07-01

One of the urgent directions of efficiency enhancement of production processes and enterprises activities management is creation and use of corporate knowledge bases. The article suggests a concept of problem-oriented corporate knowledge bases (PO CKB), in which knowledge is arranged around possible problem situations and represents a tool for making and implementing decisions in such situations. For knowledge representation in PO CKB a case-based reasoning approach is encouraged to use. Under this approach, the content of a case as a knowledge base component has been defined; based on the situation tree a PO CKB knowledge model has been developed, in which the knowledge about typical situations as well as specific examples of situations and solutions have been represented. A generalized problem-oriented corporate knowledge base structural chart and possible modes of its operation have been suggested. The obtained models allow creating and using corporate knowledge bases for support of decision making and implementing, training, staff skill upgrading and analysis of the decisions taken. The universal interpretation of terms “situation” and “solution” adopted in the work allows using the suggested models to develop problem-oriented corporate knowledge bases in different subject domains. It has been suggested to use the developed models for making corporate knowledge bases of the enterprises that operate engineer systems and networks at large production facilities.

Comparison between visual and computerized cardiotocography in low risk pregnancy

International Nuclear Information System (INIS)

Mirghani, Hisham M.; Khair, Howaida

2005-01-01

To compare between visual and computerized cardiotocography (cCTG) in low-risk pregnant women in predicting pregnancy outcome. One hundred and fifty-three consecutive computerized fetal heart tracings were recorded from non-laboring pregnant women at >/- 30 weeks gestation. All traces were reviewed by 2 experienced obstetricians. The study was carried out at Al-Ain Medical District, United Arab Emirates, between August 2004 and December 2004. Of the 153 pregnant women, 11 (7.2%) were delivered by cesarean section. The interobserver agreement was 0.60. The observers cCTG agreement were 0.48 and 0.45. The difference in cesarean section rate was not statistically significant. Observers interpretation and cCTG did not correlate well with Apgar score at 5 minutes and admission to special care baby unit. Computerized CTG has little advantage over conventional CTG in the prediction of Apgar score and need for neonatal intensive care unit admission in a low-risk population. (author)

A computerized system for improved management and execution of plant procedures

International Nuclear Information System (INIS)

Lipner, M.H.; Orendi, R.G.; Impink, A.J.; Mundy, R.A.

1987-01-01

The authors have shown how the deficiencies reported in this paper can be resolved by using the Computerized Procedures System. The Westinghouse Computerized Procedures System solves many of the human performance problems associated with procedures. It has been designed to assist plant operators in executing procedures more efficiently and cost effectively. The system brings all of the necessary information to one location for easy and continuous assessment of plant conditions and permits the operator to concentrate on the big picture

Future Orientation, Impulsivity, and Problem Behaviors: A Longitudinal Moderation Model

Science.gov (United States)

Chen, Pan; Vazsonyi, Alexander T.

2011-01-01

In the current study, based on a sample of 1,873 adolescents between 11.4 and 20.9 years of age from the first 3 waves of the National Longitudinal Study of Adolescent Health, we investigated the longitudinal effects of future orientation on levels of and developmental changes in problem behaviors, while controlling for the effects by impulsivity;…

Comparison of two interactive tutorial methods: results from a medical college in Karachi.

Science.gov (United States)

Rehan, Rabiya; Farooqi, Lubna; Khan, Hira; Rehman, Rehana

2017-02-01

To compare perception of students on usefulness of interactive tutorials and clinically-oriented problem-solving tutorials. The cross-sectional study was carried out from January 2012 to November 2013 at Bahria University Medical and Dental College, Karachi. The perception of medical students on usefulness of interactive tutorials and clinically-oriented problem-solving tutorials was acquired through a questionnaire distributed to medical students having completed the first two years of studies. The responses on various aspects of learning of physiology were acquired on a scale of poor, good or excellent. The learning abilities and acquired skills were compared in terms of not at all, to some extent, and to great extent. Data was analysed using SPSS 15. Of the hundred students initially enrolled, complete response was obtained from 83(83%). Of them, 47(57%) were females. There was significant difference in understanding of structure and function by clinically-oriented problem-solving tutorials (p=0.04). The students preferred clinically-oriented problem-solving tutorials as far as understating of difficult concepts was concerned (pskills were improved by interactive tutorials (p=0.02) whereas clinical reasoning skills acquired by clinically-oriented problem-solving tutorials was found to be significantly better (pskills were acquired more by clinically-oriented problem-solving tutorials that helped in better understanding of structure and functions.

Longitudinal retention of anatomical knowledge in second-year medical students

NARCIS (Netherlands)

Doomernik, D.E.; Goor, H. van; Kooloos, J.G.M.; Broek, R.P. ten

2017-01-01

The Radboud University Medical Center has a problem-based, learner-oriented, horizontally, and vertically integrated medical curriculum. Anatomists and clinicians have noticed students' decreasing anatomical knowledge and the disability to apply knowledge in diagnostic reasoning and problem solving.

[Vocational orientation in medical rehabilitation: development of a practice handbook and a homepage as user-oriented media for rehabilitative practice].

Science.gov (United States)

Lukasczik, M; Löffler, S; Gerlich, C; Wolf, H-D; Neuderth, S

2011-06-01

Vocational orientation in medical rehabilitation has become an important issue in rehabilitation science and practice in Germany. Although a variety of vocationally oriented interventions has been developed in recent years, there is still a lack of consensus with regard to the definition of specific types of interventions as well as relevant criteria (e. g., methods; instruments; duration/frequency; patient groups). Building on preliminary definitions, basic types of vocationally oriented measures/interventions were conceptually modified and refined in the context of a consensual process. 39 experts of various professions were contacted during a 2-stage Delphi survey to evaluate existing definitions of vocationally oriented interventions using key questions. Standardized descriptions of 5 vocationally oriented basic interventions were specified in cooperation with an interdisciplinary panel of experts. Descriptions were published in a workbook and a homepage for researchers and clinicians, which also contain information on the implementation of measures into rehabilitative care as well as good practice examples. The media developed in this project may contribute to the transfer of research results on vocationally oriented rehabilitation into health care practice. © Georg Thieme Verlag KG Stuttgart · New York.

Renal calyceal anatomy characterization with 3-dimensional in vivo computerized tomography imaging.

Science.gov (United States)

Miller, Joe; Durack, Jeremy C; Sorensen, Mathew D; Wang, James H; Stoller, Marshall L

2013-02-01

Calyceal selection for percutaneous renal access is critical for safe, effective performance of percutaneous nephrolithotomy. Available anatomical evidence is contradictory and incomplete. We present detailed renal calyceal anatomy obtained from in vivo 3-dimentional computerized tomography renderings. A total of 60 computerized tomography urograms were randomly selected. The renal collecting system was isolated and 3-dimensional renderings were constructed. The primary plane of each calyceal group of 100 kidneys was determined. A coronal maximum intensity projection was used for simulated percutaneous access. The most inferior calyx was designated calyx 1. Moving superiorly, the subsequent calyces were designated calyx 2 and, when present, calyx 3. The surface rendering was rotated to assess the primary plane of the calyceal group and the orientation of the select calyx. The primary plane of the upper pole calyceal group was mediolateral in 95% of kidneys and the primary plane of the lower pole calyceal group was anteroposterior in 95%. Calyx 2 was chosen in 90 of 97 simulations and it was appropriate in 92%. Calyx 3 was chosen in 7 simulations but it was appropriate in only 57%. Calyx 1 was not selected in any simulation and it was anteriorly oriented in 75% of kidneys. Appropriate lower pole calyceal access can be reliably accomplished with an understanding of the anatomical relationship between individual calyceal orientation and the primary plane of the calyceal group. Calyx 2 is most often appropriate for accessing the anteroposterior primary plane of the lower pole. Calyx 1 is most commonly oriented anterior. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

[Implementation of computerized phisician order entry in a hospital setting: what are the keys to success?].

Science.gov (United States)

Garçous, R; Remy, G; Bary, M; Amant, F; Cauwe, F; De Beusscher, L; Bouzette, A; De Coster, P; Hecq, J-D

2013-06-01

A software of computerized physician order entry [CPOE] was developed by a data-processing company in collaboration with the Mont-Godinne University Hospital By 2006, parallel to the evolution of the software, the progressive implementation of CPOE was carried out, and currently covers 16 wards, the emergency room, the recovery rooms and the center of medical care [day hospital] as well as the day surgical center Complete computerization of the drug supply chain, including the regulation by the physician, the pharmaceutical validation, the delivery and the follow-up of stocks by pharmacy, the validation of the administration by the nurse and the tariffing of the drugs. In 2006, a working group was created in order to validate specifications allowing the development of a software of CPOE, Linked to the computerized medical record. A data-processing company was selected in order to develop this software. Two beds were computerized in the pneumology ward, in order to test and validate the software. From 2007 to 2009, 3 additional wards were computerized [geriatrics, neurosurgery, revalidation]. A steering committee of CPOE, composed of various members (direction, doctors, pharmacists, nurses, data processing specialistsl is created. This committee allows the installation of the means necessary to the deployment of CPOE in the Institution. Structured teams for the deployment are created: medical and nurse coaches. From 2009 to 2012, the deployment of the software is carried out, covering 16 wards, the emergency room, the recovery room and the day-hospitals. The computerization of the drug supply chain is a challenge which concerns the institutional level. The assets of our hospital and our project were: - a strong management committee, making of this project a priority entering the strategical planning of the institution; - a steering committee allowing each type of actor to express his needs, and of prioriser requests; - a closer medical coaching; - teams of nurses

St. Luke's Medical Center: technologizing health care

International Nuclear Information System (INIS)

Tumanguil, S.S.

1994-01-01

The computerization of the St. Luke's Medical Center improved the hospital administration and management, particularly in nuclear medicine department. The use of computer-aided X-ray simulator machine and computerized linear accelerator machine in diagnosing and treating cancer are the most recent medical technological breakthroughs that benefited thousands of Filipino cancer patients. 4 photos

Parallel-hierarchical processing and classification of laser beam profile images based on the GPU-oriented architecture

Science.gov (United States)

Yarovyi, Andrii A.; Timchenko, Leonid I.; Kozhemiako, Volodymyr P.; Kokriatskaia, Nataliya I.; Hamdi, Rami R.; Savchuk, Tamara O.; Kulyk, Oleksandr O.; Surtel, Wojciech; Amirgaliyev, Yedilkhan; Kashaganova, Gulzhan

2017-08-01

The paper deals with a problem of insufficient productivity of existing computer means for large image processing, which do not meet modern requirements posed by resource-intensive computing tasks of laser beam profiling. The research concentrated on one of the profiling problems, namely, real-time processing of spot images of the laser beam profile. Development of a theory of parallel-hierarchic transformation allowed to produce models for high-performance parallel-hierarchical processes, as well as algorithms and software for their implementation based on the GPU-oriented architecture using GPGPU technologies. The analyzed performance of suggested computerized tools for processing and classification of laser beam profile images allows to perform real-time processing of dynamic images of various sizes.

Impact of Pharmacist-Conducted Comprehensive Medication Reviews for Older Adult Patients to Reduce Medication Related Problems.

Science.gov (United States)

Kiel, Whitney J; Phillips, Shaun W

2017-12-31

Older adults are demanding increased healthcare attention with regards to prescription use due in large part to highly complex medication regimens. As patients age, medications often have a more pronounced effect on older adults, negatively impacting patient safety and increasing healthcare costs. Comprehensive medication reviews (CMRs) optimize medications for elderly patients and help to avoid inappropriate medication use. Previous literature has shown that such CMRs can successfully identify and reduce the number of medication-related problems and improve acute healthcare utilization. The purpose of this pharmacy resident research study is to examine the impact of pharmacist-conducted geriatric medication reviews to reduce medication-related problems within a leading community health system in southwest Michigan. Furthermore, the study examines type of pharmacist interventions made during medication reviews, acute healthcare utilization, and physician assessment of the pharmacist's value. The study was conducted as a retrospective post-hoc analysis on ambulatory patients who received a CMR by a pharmacist at a primary care practice. Inclusion criteria included patients over 65 years of age with concurrent use of at least five medications who were a recent recipient of a CMR. Exclusion criteria included patients with renal failure, or those with multiple providers involved in primary care. The primary outcome was the difference in number of medication-related problems, as defined by the START and STOPP Criteria (Screening Tool to Alert doctors to Right Treatment/Screening Tool of Older Persons' Prescriptions). Secondary outcomes included hospitalizations, emergency department visits, number and type of pharmacist interventions, acceptance rate of pharmacist recommendations, and assessment of the pharmacist's value by clinic providers. There were a total of 26 patients that received a comprehensive medication review from the pharmacist and were compared to a

Benefit of Problem-Based Learning for Psychosocial Medicine: first experiences at the medical faculty of berne

Directory of Open Access Journals (Sweden)

Laederach-Hofmann, Kurt

2005-04-01

Full Text Available Aim: Presentation of skills and knowledge of medical students in psychiatry or psychosocial medicine in basic study (year 1 to 3 after the introduction of a problem oriented learning curriculum at the Medical Faculty of Berne.Method: Description of the curriculum with the different teaching units, and the evaluation by means of formative tools used by students and tutors.Results: With reference to qualitative comparison students of the problem based learning track showed a better preparation of the different teaching units than did traditional students. Moreover, compared to classical teaching, students in problem based learning rated the commitment of the teachers higher. The formative results showed a better adherence to the teaching modules, a higher effort in self learning and a higher interest in psychological or psychiatric learning items.Discussion: The higher commitment of teachers and the explicit structuring of the teaching contents in psychiatry and psychosocial medicine showed positive effects in the learning strategy of students. Beside the fact that exams have been adapted to the new curriculum one can assume that the learning style has changed. This might be a result of the better learning environment in the new curriculum. However, there is not clear how and to what extent these changes will remain active until the final exams of the medical curriculum when psychosocial contents will be reexamined.Conclusions: The intense commitment of the teachers and the better structuring of the subject matter may lead to a better integration of psychosocial and psychiatric issues into the medical curriculum.

A survey on acquaintance, orientation and behavior of general medical practitioners toward periodontal diseases

Directory of Open Access Journals (Sweden)

Supreet Kaur

2015-01-01

Full Text Available Background: An association between oral conditions such as periodontal diseases and systemic conditions is noted. As such, periodontal disease is associated with an increased risk of systemic illnesses such as cardiovascular disease, diabetes, adverse pregnancy outcome, atherosclerosis, stroke and hospital acquired pneumonia. The concept of diagnosing and treating a potential patient to minimize the deleterious effects of this chronic infectious and inflammatory condition on systemic conditions represents both an unprecedented challenge and opportunity to our profession. Keeping this in view, the present survey was designed to evaluate the acquaintance, orientation and behavior of general medical practitioners; concerning the effects of periodontal disease on systemic health. Materials and Methods: A typed questionnaire carrying four sets of questions was distributed among general medical practitioners of seven different government and private medical colleges and hospitals. Questionnaire was developed to assess the acquaintance, orientation and behavior of general medical practitioners toward periodontal disease. Results: Most of the respondents have knowledge regarding the signs and symptoms of periodontal disease and its association with cardiovascular disease. However, majority of them do not know about the potential effect of periodontal disease on other organ systems. Conclusion: General medical practitioners have inadequate knowledge regarding periodontal diseases. Hence, oral health related training should be an integral part of the medical curriculum.

A survey on acquaintance, orientation and behavior of general medical practitioners toward periodontal diseases.

Science.gov (United States)

Kaur, Supreet; Khurana, Pankaj; Kaur, Harjit

2015-01-01

An association between oral conditions such as periodontal diseases and systemic conditions is noted. As such, periodontal disease is associated with an increased risk of systemic illnesses such as cardiovascular disease, diabetes, adverse pregnancy outcome, atherosclerosis, stroke and hospital acquired pneumonia. The concept of diagnosing and treating a potential patient to minimize the deleterious effects of this chronic infectious and inflammatory condition on systemic conditions represents both an unprecedented challenge and opportunity to our profession. Keeping this in view, the present survey was designed to evaluate the acquaintance, orientation and behavior of general medical practitioners; concerning the effects of periodontal disease on systemic health. A typed questionnaire carrying four sets of questions was distributed among general medical practitioners of seven different government and private medical colleges and hospitals. Questionnaire was developed to assess the acquaintance, orientation and behavior of general medical practitioners toward periodontal disease. Most of the respondents have knowledge regarding the signs and symptoms of periodontal disease and its association with cardiovascular disease. However, majority of them do not know about the potential effect of periodontal disease on other organ systems. General medical practitioners have inadequate knowledge regarding periodontal diseases. Hence, oral health related training should be an integral part of the medical curriculum.

Medical device problem reporting for the betterment of healthcare.

Science.gov (United States)

1998-08-01

Given that there are nearly 5,000 individual classes of medical devices, tens of thousands of medical device suppliers, and millions of healthcare providers around the world, device-related problems are bound to happen. But effective problem reporting can help reduce or eliminate many of these problems--not only within an institution, but also potentially around the world. In this article, we trace the problem reporting process from its beginnings in the hospital to its global impact in making critical information available throughout the healthcare community.

Collaborative diagramming during problem based learning in medical education: Do computerized diagrams support basic science knowledge construction?

Science.gov (United States)

De Leng, Bas; Gijlers, Hannie

2015-05-01

To examine how collaborative diagramming affects discussion and knowledge construction when learning complex basic science topics in medical education, including its effectiveness in the reformulation phase of problem-based learning. Opinions and perceptions of students (n = 70) and tutors (n = 4) who used collaborative diagramming in tutorial groups were collected with a questionnaire and focus group discussions. A framework derived from the analysis of discourse in computer-supported collaborative leaning was used to construct the questionnaire. Video observations were used during the focus group discussions. Both students and tutors felt that collaborative diagramming positively affected discussion and knowledge construction. Students particularly appreciated that diagrams helped them to structure knowledge, to develop an overview of topics, and stimulated them to find relationships between topics. Tutors emphasized that diagramming increased interaction and enhanced the focus and detail of the discussion. Favourable conditions were the following: working with a shared whiteboard, using a diagram format that facilitated distribution, and applying half filled-in diagrams for non-content expert tutors and\\or for heterogeneous groups with low achieving students. The empirical findings in this study support the findings of earlier more descriptive studies that diagramming in a collaborative setting is valuable for learning complex knowledge in medicine.

A descriptive study of medical educators' views of problem-based learning

Directory of Open Access Journals (Sweden)

Dennick Reg

2009-11-01

Full Text Available Abstract Background There is a growing amount of literature on the benefits and drawbacks of Problem-Based Learning (PBL compared to conventional curricula. However, it seems that PBL research studies do not provide information rigorously and formally that can contribute to making evidence-based medical education decisions. The authors performed an investigation aimed at medical education scholars around the question, "What are the views of medical educators concerning the PBL approach?" Methods After framing the question, the method of data collection relied on asking medical educators to report their views on PBL. Two methods were used for collecting data: the questionnaire survey and an online discussion forum. Results The descriptive analysis of the study showed that many participants value the PBL approach in the practice and training of doctors. However, some participants hold contrasting views upon the importance of the PBL approach in basic medical education. For example, more than a third of participants (38.5% had a neutral stance on PBL as a student-oriented educational approach. The same proportion of participants also had a neutral view of the efficiency of traditional learning compared to a PBL tutorial. The open-ended question explored the importance of faculty development in PBL. A few participants had negative perceptions of the epistemological assumptions of PBL. Two themes emerged from the analysis of the forum repliers: the importance of the faculty role and self-managed education. Conclusion Whilst many participants valued the importance of the PBL approach in the practice and training of doctors and agreed with most of the conventional descriptions of PBL, some participants held contrasting views on the importance of the PBL approach in undergraduate medical education. However there was a strong view concerning the importance of facilitator training. More research is needed to understand the process of PBL better.

Safety-technical comparison of a hard-wired dynamic reactor protection system with a computerized alternative. Pt. 2

International Nuclear Information System (INIS)

Buettner, W.E.

1978-03-01

The investigation presented here compares a conventional hard-wired dynamic reactor protection system with a computerized alternative. For both systems the spurious trip probability is determined, i.e. the probability of a false release of one or more protection actions due to failures. The mean unavailability is also determined for those not distinctly safety-oriented protection actions of the computerized protection system which are released via the open circuit current principle. This is because system breakdowns prevent the release of those protection actions in case of demand. The advantages and disadvantages of either type of system are viewed against each other. (orig.) [de

Personality Makes a Difference: Attachment Orientation Moderates Theory of Planned Behavior Prediction of Cardiac Medication Adherence.

Science.gov (United States)

Peleg, Shira; Vilchinsky, Noa; Fisher, William A; Khaskia, Abed; Mosseri, Morris

2017-12-01

To achieve a comprehensive understanding of patients' adherence to medication following acute coronary syndrome (ACS), we assessed the possible moderating role played by attachment orientation on the effects of attitudes, subjective norms, and perceived behavioral control (PBC), as derived from the Theory of Planned Behavior (TPB; Ajzen, 1991), on intention and reported adherence. A prospective longitudinal design was employed. During hospitalization, ACS male patients (N = 106) completed a set of self-report questionnaires including sociodemographic variables, attachment orientation, and measures of TPB constructs. Six months post-discharge, 90 participants completed a questionnaire measuring adherence to medication. Attachment orientations moderated some of the predictions of the TPB model. PBC predicted intention and reported adherence, but these associations were found to be significant only among individuals with lower, as opposed to higher, attachment anxiety. The association between attitudes and intention was stronger among individuals with higher, as opposed to lower, attachment anxiety. Only among individuals with higher attachment avoidance, subjective norms were negatively associated with intention to take medication. Cognitive variables appear to explain both adherence intention and behavior, but differently, depending on individuals' attachment orientations. Integrating personality and cognitive models may prove effective in understanding patients' health behaviors. © 2016 Wiley Periodicals, Inc.

The role of metacognitive skills in solving object-oriented programming problems: a case study

Directory of Open Access Journals (Sweden)

Marietjie Havenga

2015-07-01

Full Text Available This article reports on the role of metacognitive skills when solving object-oriented programming problems as part of a case study. The research was constructivist-based within an interpretivist approach to explore how four students constructed their own thinking when solving programming problems. A qualitative methodology was employed. Both concept-driven coding and data-driven coding were applied. Two main issues emerged from the findings. Participating students had fragmented knowledge of the object-oriented approach and shortcomings regarding the implementation thereof, and they experienced problems with metacognitive control during all the steps of program development. Based on the findings the use of metacognitive critical control points (MCCPs is proposed to be used as a mechanism to facilitate students in their programming efforts and to prevent loss of control during program development.

Safety problems with the use of medical equipment/devices

NARCIS (Netherlands)

Rademakers, C.

2009-01-01

In the past decennia medical technology has rapidly developed. Nowadays it plays an important role in all medical fields. It introduced technologic solutions for many medical problems and it definitely increased the possibilities in the medical field to increase the quality of life. However with

Social and physiological peculiarities and professional orientation of medical students

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O. V. Toussova

2015-01-01

Full Text Available The article describes personality features, self-regulation patterns and professional orientation of medical students. It represents the results of the study conducted among the fourth year students. The sample is characterized with high enough behavior regulation, extraversion, high learning potential, flexible thinking, following intuition and personal opinion in profession choice. High anxiety as personality feature and stress vulnerability is typical for female students; independence tendency is typical for male students.

Empathic orientation among medical students from three universities in Barranquilla, Colombia and one university in the Dominican Republic.

Science.gov (United States)

Díaz Narváez, Víctor Patricio; Alonso Palacio, Luz Marina; Caro, Sara Elvira; Silva, María Guadalupe; Castillo, Joel Arboleda; Bilbao, Jorge Luis; Acosta, Jesús Iglesias

2014-02-01

To compare empathic orientation among medical students from three schools of medicine in Colombia and one in the Dominican Republic. Empathic orientation of medical students was measured using the Jefferson Scale of Physician Empathy (JSPE), Spanish version for students (the "S" version) validated in Mexico and Chile, and culturally adapted to Colombia and the Dominican Republic. Data were compared using a three-factor analysis of variance (model III) and a discriminant analysis. No differences in empathic orientation were observed among courses and between sexes, but differences were found in schools of medicine considered as a unit in each studied country. Empathic orientation levels tend to reduce as courses advance. This was observed in both male and female students and in all schools analyzed.

Social dominance orientation and opinions about what is America's most serious social problem.

Science.gov (United States)

Harrod, Wendy J

2005-08-01

This study tested whether a measure of Social Dominance Orientation was associated with opinions about America's most serious social problem. 150 undergraduates enrolled in social problems classes responded to the 14-item scale and to an open-ended question, "In your opinion, what is the most serious social problem in our country today?". Analysis shows that mean scale scores differed significantly across social problem responses. Correspondence analysis, plotting association between scale scores and social problem responses, was interpreted as support for social dominance theory. Higher scale scores were associated with problems of crime and negative values and lower scores with problems of education and racism.

Development of a computerized tomographic system

International Nuclear Information System (INIS)

Borges, J.C.; Santos, C.A.C.

1986-01-01

The Nuclear Instrumentation Laboratory at COPPE/UFRJ has been developing techniques for detection and applications of nuclear radiations. A lot of research work has been done and resulted in several M.Sc. and D.Sc. thesis, concerning subjects like neutrongraphy, gammagraphy, image reconstruction, special detectors, etc. Recent progress and multiple applications of the computerized tomography to medical and industrial non-destructive tests, pushed the Laboratory to a vast program in this field of research. In this paper, we report what has been done and the results obtained. (Author) [pt

Contraception for the first time users: a problem-orientated guide to ...

African Journals Online (AJOL)

Contraception for the first time users: a problem-orientated guide to product selection and safe prescription. W M Kruger, O S Steyn. Abstract. No Abstract South African Family Practice Vol. 49 (8) 2007: pp.44-50. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL ...

Effect of a system-oriented intervention on compliance problems in schizophrenia

DEFF Research Database (Denmark)

Skarsholm, Hanne; Støvring, Henrik; Nielsen, Bent

2014-01-01

Background. Numerous studies have been conducted with a view to developing strategies for improvement of medical compliance in patients with schizophrenia. All of the studies conducted so far have had an individual approach to compliance based on the assumption that noncompliance is determined...... individually due to inappropriate behavior in the patient. We conducted a pragmatic controlled trial with a system-oriented approach, to provide a new perspective on compliance and test the efficacy of a multifactorial intervention at the system level in a routine clinical setting, an approach that has...... not previously been used for the improvement of compliance. Methods. 30 patients were allocated to the system-oriented therapy and 40 patients were allocated to the reference intervention, which consisted of individually based compliance therapy. The follow-up period was six months. Primary endpoint...

Multiple Maximum Exposure Rates in Computerized Adaptive Testing

Science.gov (United States)

Ramon Barrada, Juan; Veldkamp, Bernard P.; Olea, Julio

2009-01-01

Computerized adaptive testing is subject to security problems, as the item bank content remains operative over long periods and administration time is flexible for examinees. Spreading the content of a part of the item bank could lead to an overestimation of the examinees' trait level. The most common way of reducing this risk is to impose a…

[Methods for teaching problem-solving in medical schools].

Science.gov (United States)

Shumway, J M; Vargas, M E; Heller, L E

1984-01-01

The need to include in the medical curriculum instructional activities to promote the development of problem-solving abilities has been asserted at the national and international levels. In research on the mental process involved in the solution of problems in medicine, problem-solving has been defined as a hypothetical-deductive activity engaged in by experienced physicians, in which the early generation of hypotheses influences the subsequent gathering of information. This article comments briefly on research on the mental process by which medical problems are solved. It describes the methods that research has shown to be most applicable in instruction to develop problem-solving abilities, and presents some educational principles that justify their application. The "trail-following" approach is the method that has been most commonly used to study the physician's problem-solving behavior. The salient conclusions from this research are that in the problem-solving process the diagnostic hypothesis is generated very early on and with limited data; the number of hypotheses is small; the problem-solving approach is specific to the type of medical problem and case in hand; and the accumulation of medical knowledge and experience forms the basis of clinical competence. Four methods for teaching the solution of problems are described: case presentation, the rain of ideas, the nominal groups technique and decision-making consensus, the census and analysis of forces in the field, and the analysis of clinical decisions. These methods are carried out in small groups. The advantages of the small groups are that the students are active participants in the learning process, they receive formative evaluation of their performance in a setting conductive to learning, and are able to interact with their instructor if he makes proper use of the right questioning techniques. While no single problem-solving method can be useful to all students or in all the problems they encounter

Self-Regulation and Problem Solving Ability in 7E-Learning Cycle Based Goal Orientation

Science.gov (United States)

Mulyono; Noor, N. L.

2017-04-01

Goal orientation differences between mastery goals and performance goals can be a cause of high and low self-regulation and problem-solving abilities. To overcome these problems applied 7E-learning cycle in which students learn and develop ways to optimise the power of reason through the learning phase elicit, engage, explore, explain, elaborate, evaluate, and extend. This study aimed to test the effectiveness of learning by 7E-learning cycle and describe self-regulation and mathematics problem solving based on goal-orientation after the implementation 7E-learning cycle. This study used mix method design with research subject is graders XII sciences MA NU Nurul Ulum Jekulo Kudus which divided into goal orientation is mastery goal and performance goal. The independent variable of this research is learning model, while the dependent variable is problem solving and self-regulation. Then, collecting data using scale, interviews and tests. The data processed with the proportion of test, t-test, paired samples t-test, and Normality-gain. The results show problem-solving abilities of students through 7E-learning cycle the average of mathematical problem-solving capability class, self-regulation at 7E-learning cycle is better than the traditional model study. The problem-solving skills at 7E-learning cycle are better than the traditional model study, there is an increase in self-regulation through 7E-learning cycle of 0.4 (medium), and there is an increased problem-solving ability through 7E-learning cycle by 0.79 (high). Based on the qualitative analysis, self-regulation and problem-solving ability after the implementation of 7E-learning cycle students of a mastery goal group are better than the performance goal team. It is suggested to implement 7E-learning cycle to improve self-regulation and problem-solving ability as well as directing and fostering mastery goal on the student in the learning process.

Medical problems of porters and trekkers in the Nepal Himalaya.

Science.gov (United States)

Basnyat, B; Litch, J A

1997-05-01

The purpose of this study was to assess the incidence of medical illness among members of trekking groups in the Nepal Himalaya. The design was a cohort study using interview and clinical examination by a single physician. The setting was the Manaslu area in the central Nepal Himalaya along a 22-day trekking route with elevations ranging from 487 m to 5100 m. Subjects were 155 members of commercial trekking groups: 102 Nepali porters, 31 Nepali trek staff, and 22 Western trekkers. We found that medical problems occurred in 45% of party members. The porter cohort contained the highest diversity and severity of illness. The relatively larger porter cohort experienced 77% of the medical problems recorded compared with 17% among Western trekkers and 6% among trek staff. The incidence of medical problems was not significantly different in the porter staff (52%) and Western trekkers (55%) and was significantly lower for the trek staff (13%). High-altitude pharyngitis/bronchitis was the most common illness in the party (12%) followed by acute mountain sickness (8%) and gastroenteritis (6%). Other conditions included anxiety (3%), cellulitis (3%), scabies (3%), snow blindness (3%), acute alcohol intoxication (2%), conjunctivitis (2%), fever (2%), lacerations (2%), and hemorrhoids (1%). Illness with infectious etiologies comprised 33% of the medical problems. The incidence of altitude illness was not significantly less in the Nepali porter staff than in the Western trekkers. Evacuation was required in 5% of party members, all from the porter group. This study should alert expedition medical providers and trip leaders of the need to be observant for and prepared to treat the frequent and diverse medical problems among the porter staff in their party, in addition to the Western members. Medical problems are common in remote mountainous areas, indicating that trip physicians should be experienced in primary care.

Intersecting Identities and Substance Use Problems: Sexual Orientation, Gender, Race, and Lifetime Substance Use Problems

Science.gov (United States)

Mereish, Ethan H.; Bradford, Judith B.

2014-01-01

Objective: Research has documented that sexual minorities are at greater risk for substance use than heterosexuals. However, there are limited studies and mixed findings when investigating these health disparities among racial and ethnic minority samples. We used an intersectionality framework to examine disparities in lifetime substance use problems between heterosexual and sexual minority men and women and within sexual minority groups among a racially diverse sample. Method: A nonprobability sample of heterosexual (n = 1,091) and sexual minority (n = 1,465) patients from an urban community health center ranged in age from 18 to 72 years. Participants completed a brief patient survey and reported demographic information and history of lifetime substance use problems. Logistic regressions analyses were used to examine interactions between and among sexual orientation, gender, and race. Results: We found a significant three-way interaction among sexual orientation, gender, and race. Sexual minorities had a greater risk of self-reported lifetime substance use problems than heterosexuals, with nuanced gender and racial differences. Of greatest note, sexual minority women of color had greater risks than heterosexual women of color and than White sexual minority women. Sexual minority men of color did not differ in their risk when compared with heterosexual men of color, and they had lower risk than White sexual minority men. Conclusions: The results of this study demonstrate that an intersectionality framework is crucial to clearly identify lifetime substance use disparities between racially diverse sexual minority and heterosexual men and women. Future research, treatment, and policy should use intersectionality approaches when addressing substance use disparities. PMID:24411810

Ancient medical texts, modern reading problems

Directory of Open Access Journals (Sweden)

Maria Carlota Rosa

2006-12-01

Full Text Available The word tradition has a very specific meaning in linguistics: the passing down of a text, which may have been completed or corrected by different copyists at different times, when the concept of authorship was not the same as it is today. When reading an ancient text the word tradition must be in the reader's mind. To discuss one of the problems an ancient text poses to its modern readers, this work deals with one of the first printed medical texts in Portuguese, the Regimento proueytoso contra ha pestenença, and draws a parallel between it and two related texts, A moche profitable treatise against the pestilence, and the Recopilaçam das cousas que conuem guardar se no modo de preseruar à Cidade de Lixboa E os sãos, & curar os que esteuerem enfermos de Peste. The problems which arise out of the textual structure of those books show how difficult is to establish a tradition of another type, the medical tradition. The linguistic study of the innumerable medieval plague treatises may throw light on the continuities and on the disruptions of the so-called hippocratic-galenical medical tradition.

Sleep-related problems in common medical conditions.

Science.gov (United States)

Parish, James M

2009-02-01

Common medical problems are often associated with abnormalities of sleep. Patients with chronic medical disorders often have fewer hours of sleep and less restorative sleep compared to healthy individuals, and this poor sleep may worsen the subjective symptoms of the disorder. Individuals with lung disease often have disturbed sleep related to oxygen desaturations, coughing, or dyspnea. Both obstructive lung disease and restrictive lung diseases are associated with poor quality sleep. Awakenings from sleep are common in untreated or undertreated asthma, and cause sleep disruption. Gastroesophageal reflux is a major cause of disrupted sleep due to awakenings from heartburn, dyspepsia, acid brash, coughing, or choking. Patients with chronic renal disease commonly have sleep complaints often due to insomnia, insufficient sleep, sleep apnea, or restless legs syndrome. Complaints related to sleep are very common in patients with fibromyalgia and other causes of chronic pain. Sleep disruption increases the sensation of pain and decreases quality of life. Patients with infectious diseases, including acute viral illnesses, HIV-related disease, and Lyme disease, may have significant problems with insomnia and hypersomnolence. Women with menopause have from insomnia, sleep-disordered breathing, restless legs syndrome, or fibromyalgia. Patients with cancer or receiving cancer therapy are often bothered by insomnia or other sleep disturbances that affect quality of life and daytime energy. The objective of this article is to review frequently encountered medical conditions and examine their impact on sleep, and to review frequent sleep-related problems associated with these common medical conditions.

Medical student's perspective of problem based learning (PBL ...

African Journals Online (AJOL)

The Faculty of Health Sciences at the University of Transkei has completed the first 5 years of its problem-based community oriented teaching curriculum. The use of SWOT analysis to evaluate current and future directions can lead to the successful evolution of any organization. The aim of this study was to obtain a students' ...

From cases to projects in problem-based medical education

Directory of Open Access Journals (Sweden)

Diana Stentoft

2014-06-01

Full Text Available Problem-based learning (PBL based on patient cases has become a well-established worldwide educational approach in medical education. Recent studies indicate that case-based PBL when used throughout an entire curriculum may develop into a counter-productive routine for students as well as teachers. Consequently, there is a need to develop PBL approaches further allowing students to work with more ill-defined problems and alternative learning structures. In this paper, we argue that this can be realised by introducing project-PBL into the medical curriculum, as in the medical education at Aalborg University, Denmark. We outline organisations of case- and project- PBL in the medical curriculum and present an explorative study of 116 first and second year students’ experiences working in the two settings of PBL. Results reveal that students generally rate their PBL experiences positively however, project-PBL is rated more positively than case-PBL on all parameters studied. These results invite further consideration of the differences in working with cases and projects. Two central differences are discussed; the nature of the problem as the trigger of learning and students' possibilities for directing their own learning processes. The study demonstrates that introducing project-PBL may contribute significantly in problem-based medical education. However, the need for extensive research into advantages and limitations of the combined use of case- and project-PBL is also emphasised.

Problems of medical personnel deontology during radiation emergency response

International Nuclear Information System (INIS)

Poplavskij, K.K.; Popov, A.O.

1990-01-01

Problems of deontology in the process of liquidation of radiation accident consequences are considered in the article. It is noted, that shortages of ethical nature in the activities of physicians are related to insufficient qualification of medical personnel in the area of radiation medicine. Problems of medical personnel participation in the large scale propaganda activities among various groups of population are considered. 5 refs

Computerized materials protection, control, and accountability

International Nuclear Information System (INIS)

Whiteson, R.; Seitz, S.; Landry, R.P.; Hadden, M.L.; Painter, J.A.

1997-01-01

The proliferation of nuclear weapons, along with the technical knowledge and materials needed to make these weapons, is an enduring problem of international urgency. Current international nuclear nonproliferation efforts are aimed at deterring, detecting, and responding to proliferation of weapons of mass destruction. These safeguards efforts are being implemented by applying preeminent science and technology to the management and control of nuclear materials. By strengthening systems of nuclear material protection, control, and accountability (MPC and A), one can reduce the threat of nuclear weapons proliferation. Two major programs of international cooperation are now underway to achieve this goal. The first is between the US Department of Energy (DOE) and the Institutes of the Russian Federation (Laboratory-to-Laboratory Program), and the second is between the US Government and Governments of the former Soviet Republics (Government-to-Government Program). As part of these programs, the DOE is working with facilities to assist them in implementing computerized MPC and A systems. This work is a collaboration between computer scientists and safeguards experts in both the US and the new Republics. The US is making available technology and expertise to enable Russian experts to build on computerized MPC and A software developed in the US. This paper describes the joint efforts of these international teams to develop sophisticated computerized MPC and A systems using modern computer hardware and software technology. These systems are being customized to meet the site-specific needs of each facility

Problem-oriented clinical microbiology and infection. 2nd. ed.

Energy Technology Data Exchange (ETDEWEB)

Hilary Humphreys; William, L. Irving [Royal College of Surgeons (Ireland)

2004-08-01

This medical textbook is problem-based, in line with current medical teaching, and covers 70 clinical cases. This second edition has been updated to include new material on AIDS/HIV, emerging antibiotic-resistant bacteria and new viral pathogens such as SARS. Sections are headed; Skin and mucous membranes; Respiratory tract; Gastrointestinal system which includes a case study entitled: Bob, a 55-year-old retired coal miner with abdominal pain; Genito-urinary system; Central nervous system; Systemic infections; Pregnancy and the neonate; and Miscellaneous. 29 ills., 125 photos.

OR.NET: a service-oriented architecture for safe and dynamic medical device interoperability.

Science.gov (United States)

Kasparick, Martin; Schmitz, Malte; Andersen, Björn; Rockstroh, Max; Franke, Stefan; Schlichting, Stefan; Golatowski, Frank; Timmermann, Dirk

2018-02-23

Modern surgical departments are characterized by a high degree of automation supporting complex procedures. It recently became apparent that integrated operating rooms can improve the quality of care, simplify clinical workflows, and mitigate equipment-related incidents and human errors. Particularly using computer assistance based on data from integrated surgical devices is a promising opportunity. However, the lack of manufacturer-independent interoperability often prevents the deployment of collaborative assistive systems. The German flagship project OR.NET has therefore developed, implemented, validated, and standardized concepts for open medical device interoperability. This paper describes the universal OR.NET interoperability concept enabling a safe and dynamic manufacturer-independent interconnection of point-of-care (PoC) medical devices in the operating room and the whole clinic. It is based on a protocol specifically addressing the requirements of device-to-device communication, yet also provides solutions for connecting the clinical information technology (IT) infrastructure. We present the concept of a service-oriented medical device architecture (SOMDA) as well as an introduction to the technical specification implementing the SOMDA paradigm, currently being standardized within the IEEE 11073 service-oriented device connectivity (SDC) series. In addition, the Session concept is introduced as a key enabler for safe device interconnection in highly dynamic ensembles of networked medical devices; and finally, some security aspects of a SOMDA are discussed.

Computerized accountability program is operating - DYMCAS

International Nuclear Information System (INIS)

Combs, S.W.; Mee, W.T.

1983-01-01

The nuclear materials control and accountability program in the Oak Ridge Y-12 Plant has been placed on a computerized system identified as DYMCAS (Dynamic Special Nuclear Materials Control and Accountability System). The primary gola of the DYMCAS is to assist in detecting the diversion of special nuclear material (SNM). Secondly, the system is expected to assure quality inventory reconciliations both under normal and emergency situations. The system has been installed and was placed on active status in April 1982. Since that time numerous problems have surfaced and been resolved; i.e., delays of input, hardware breakdown, and misunderstandings of needs. An explanation of these problems, including examples and alterations that have made the system workable, are presented

Impact of a computerized provider radiography order entry system without clinical decision support on emergency department medical imaging requests.

Science.gov (United States)

Claret, Pierre-Géraud; Bobbia, Xavier; Macri, Francesco; Stowell, Andrew; Motté, Antony; Landais, Paul; Beregi, Jean-Paul; de La Coussaye, Jean-Emmanuel

2016-06-01

The adoption of computerized physician order entry is an important cornerstone of using health information technology (HIT) in health care. The transition from paper to computer forms presents a change in physicians' practices. The main objective of this study was to investigate the impact of implementing a computer-based order entry (CPOE) system without clinical decision support on the number of radiographs ordered for patients admitted in the emergency department. This single-center pre-/post-intervention study was conducted in January, 2013 (before CPOE period) and January, 2014 (after CPOE period) at the emergency department at Nîmes University Hospital. All patients admitted in the emergency department who had undergone medical imaging were included in the study. Emergency department admissions have increased since the implementation of CPOE (5388 in the period before CPOE implementation vs. 5808 patients after CPOE implementation, p=.008). In the period before CPOE implementation, 2345 patients (44%) had undergone medical imaging; in the period after CPOE implementation, 2306 patients (40%) had undergone medical imaging (p=.008). In the period before CPOE, 2916 medical imaging procedures were ordered; in the period after CPOE, 2876 medical imaging procedures were ordered (p=.006). In the period before CPOE, 1885 radiographs were ordered; in the period after CPOE, 1776 radiographs were ordered (pmedical imaging did not vary between the two periods. Our results show a decrease in the number of radiograph requests after a CPOE system without clinical decision support was implemented in our emergency department. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Computerized extraction of information on the quality of diabetes care from free text in electronic patient records of general practitioners

NARCIS (Netherlands)

Voorham, Jaco; Denig, Petra

2007-01-01

Objective: This study evaluated a computerized method for extracting numeric clinical measurements related to diabetes care from free text in electronic patient records (EPR) of general practitioners. Design and Measurements: Accuracy of this number-oriented approach was compared to manual chart

Problem-oriented software for the managing of uranium mining by in-situ leaching

International Nuclear Information System (INIS)

Noskov, M.D.; Gutsul, M.V.; Istomin, A.D.; Kesler, A.G.; Noskova, S.N.; Cheglokov, A.A.

2013-01-01

The problem-oriented software consisting of interconnected geological geoinformation, technological information, geotechnological modeling and expert-analytical systems is presented. The software application procedure for the managing of uranium field development by in-situ leaching is considered [ru

Medical social consequences of the safety problems of oncological radiology

International Nuclear Information System (INIS)

Pilipenko, M.Yi.; Stadnik, L.L.; Shal'opa, O.Yu.; Rigan, M.M.; Skalets'kij, Yu.M.

2015-01-01

Actuality of the problem of patient safety in oncoradiology in Ukraine is grounded. The results of international audit TLD (IAEA/WHO) quality during dosimetry procedures cobalt-telegamma vehicles in Ukraine are investigated, as well as legal and regulatory framework providing for the safety of radiotherapy care, scientific publications on patient safety. Methods: statistical, analytical, bibliographical, systematic approach. On the example of radiation therapy using the results of the international program of the IAEA/WHO TLD audit quality dosimetry calibration devices for remote gamma therapy in Ukraine from 1998 to 2014 the attempt to assess the extent of medical and social consequences of underestimating of medical errors in oncoradiology is made. The problems of regulatory nature of medical errors in oncoradiology are preliminary identified. The problem of medical errors in the treatment of cancer radiation methods in Ukraine is extremely important. Usually the problems of errors in oncoradiology are considered in organizational, technical, personnel and technical aspects, while medical and social consequences of problem are not covered. About 10 thousand of cancer patients in year may suffer from errors related only to dose calculation according to the optimistic variant, while the number of patients for the same period on the pessimistic case can reach 15 thousand. There are a number of legal character problems in oncoradiology related to patient safety that require clarification. The first priority for improving the safety of patients in oncoradiology is the recording and analysis of radiation therapy defects and their consequences

Problem-based learning at the receiving end: a 'mixed methods' study of junior medical students' perspectives.

Science.gov (United States)

Maudsley, Gillian; Williams, Evelyn M I; Taylor, David C M

2008-11-01

Qualitative insights about students' personal experience of inconsistencies in implementation of problem-based learning (PBL) might help refocus expert discourse about good practice. This study explored how junior medical students conceptualize: PBL; good tutoring; and less effective sessions. Participants comprised junior medical students in Liverpool 5-year problem-based, community-orientated curriculum. Data collection and analysis were mostly cross-sectional, using inductive analysis of qualitative data from four brief questionnaires and a 'mixed' qualitative/quantitative approach to data handling. The 1999 cohort (end-Year 1) explored PBL, generated 'good tutor' themes, and identified PBL (dis)advantages (end-Year 1 then mid-Year 3). The 2001 cohort (start-Year 1) described critical incidents, and subsequently (end-Year 1) factors in less effective sessions. These factors were coded using coding-frames generated from the answers about critical incidents and 'good tutoring'. Overall, 61.2% (137), 77.9% (159), 71.0% (201), and 71.0% (198) responded to the four surveys, respectively. Responders perceived PBL as essentially process-orientated, focused on small-groupwork/dynamics and testing understanding through discussion. They described 'good tutors' as knowing when and how to intervene without dominating (51.1%). In longitudinal data (end-Year 1 to mid-Year 3), the main perceived disadvantage remained lack of 'syllabus' (and related uncertainty). For less effective sessions (end-Year 1), tutor transgressions reflected unfulfilled expectations of good tutors, mostly intervening poorly (42.6% of responders). Student transgressions reflected the critical incident themes, mostly students' own lack of work/preparation (54.8%) and other students participating poorly (33.7%) or dominating/being self-centred (31.6%). Compelling individual accounts of uncomfortable PBL experiences should inform improvements in implementation.

Solution verification, goal-oriented adaptive methods for stochastic advection–diffusion problems

KAUST Repository

Almeida, Regina C.

2010-08-01

A goal-oriented analysis of linear, stochastic advection-diffusion models is presented which provides both a method for solution verification as well as a basis for improving results through adaptation of both the mesh and the way random variables are approximated. A class of model problems with random coefficients and source terms is cast in a variational setting. Specific quantities of interest are specified which are also random variables. A stochastic adjoint problem associated with the quantities of interest is formulated and a posteriori error estimates are derived. These are used to guide an adaptive algorithm which adjusts the sparse probabilistic grid so as to control the approximation error. Numerical examples are given to demonstrate the methodology for a specific model problem. © 2010 Elsevier B.V.

Solution verification, goal-oriented adaptive methods for stochastic advection–diffusion problems

KAUST Repository

Almeida, Regina C.; Oden, J. Tinsley

2010-01-01

A goal-oriented analysis of linear, stochastic advection-diffusion models is presented which provides both a method for solution verification as well as a basis for improving results through adaptation of both the mesh and the way random variables are approximated. A class of model problems with random coefficients and source terms is cast in a variational setting. Specific quantities of interest are specified which are also random variables. A stochastic adjoint problem associated with the quantities of interest is formulated and a posteriori error estimates are derived. These are used to guide an adaptive algorithm which adjusts the sparse probabilistic grid so as to control the approximation error. Numerical examples are given to demonstrate the methodology for a specific model problem. © 2010 Elsevier B.V.

PROBLEMS AND LIMITATIONS OF SATELLITE IMAGE ORIENTATION FOR DETERMINATION OF HEIGHT MODELS

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K. Jacobsen

2017-05-01

Full Text Available The usual satellite image orientation is based on bias corrected rational polynomial coefficients (RPC. The RPC are describing the direct sensor orientation of the satellite images. The locations of the projection centres today are without problems, but an accuracy limit is caused by the attitudes. Very high resolution satellites today are very agile, able to change the pointed area over 200km within 10 to 11 seconds. The corresponding fast attitude acceleration of the satellite may cause a jitter which cannot be expressed by the third order RPC, even if it is recorded by the gyros. Only a correction of the image geometry may help, but usually this will not be done. The first indication of jitter problems is shown by systematic errors of the y-parallaxes (py for the intersection of corresponding points during the computation of ground coordinates. These y-parallaxes have a limited influence to the ground coordinates, but similar problems can be expected for the x-parallaxes, determining directly the object height. Systematic y-parallaxes are shown for Ziyuan-3 (ZY3, WorldView-2 (WV2, Pleiades, Cartosat-1, IKONOS and GeoEye. Some of them have clear jitter effects. In addition linear trends of py can be seen. Linear trends in py and tilts in of computed height models may be caused by limited accuracy of the attitude registration, but also by bias correction with affinity transformation. The bias correction is based on ground control points (GCPs. The accuracy of the GCPs usually does not cause some limitations but the identification of the GCPs in the images may be difficult. With 2-dimensional bias corrected RPC-orientation by affinity transformation tilts of the generated height models may be caused, but due to large affine image deformations some satellites, as Cartosat-1, have to be handled with bias correction by affinity transformation. Instead of a 2-dimensional RPC-orientation also a 3-dimensional orientation is possible, respecting the

Problems and Limitations of Satellite Image Orientation for Determination of Height Models

Science.gov (United States)

Jacobsen, K.

2017-05-01

The usual satellite image orientation is based on bias corrected rational polynomial coefficients (RPC). The RPC are describing the direct sensor orientation of the satellite images. The locations of the projection centres today are without problems, but an accuracy limit is caused by the attitudes. Very high resolution satellites today are very agile, able to change the pointed area over 200km within 10 to 11 seconds. The corresponding fast attitude acceleration of the satellite may cause a jitter which cannot be expressed by the third order RPC, even if it is recorded by the gyros. Only a correction of the image geometry may help, but usually this will not be done. The first indication of jitter problems is shown by systematic errors of the y-parallaxes (py) for the intersection of corresponding points during the computation of ground coordinates. These y-parallaxes have a limited influence to the ground coordinates, but similar problems can be expected for the x-parallaxes, determining directly the object height. Systematic y-parallaxes are shown for Ziyuan-3 (ZY3), WorldView-2 (WV2), Pleiades, Cartosat-1, IKONOS and GeoEye. Some of them have clear jitter effects. In addition linear trends of py can be seen. Linear trends in py and tilts in of computed height models may be caused by limited accuracy of the attitude registration, but also by bias correction with affinity transformation. The bias correction is based on ground control points (GCPs). The accuracy of the GCPs usually does not cause some limitations but the identification of the GCPs in the images may be difficult. With 2-dimensional bias corrected RPC-orientation by affinity transformation tilts of the generated height models may be caused, but due to large affine image deformations some satellites, as Cartosat-1, have to be handled with bias correction by affinity transformation. Instead of a 2-dimensional RPC-orientation also a 3-dimensional orientation is possible, respecting the object height

INTEGRATION PECULIARITIES OF COMPUTERIZED MEANS OF EDUCATION INTO THE PROCESS OF TEACHER TRAINING AT PEDAGOGICAL COLLEGES

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Olga M. Naumenko

2010-08-01

Full Text Available Important problems of using the computerized means of education in the process of teacher training at pedagogical college are considered. On the basis of the analysis of the organisation of educational process in different pedagogical colleges, the general principles of construction of the educational module “Methodology of computerized means of education in educational process” are considered.

Between professional autonomy and economic orientation - The medical profession in a changing health care system.

Science.gov (United States)

Kälble, Karl

2005-02-17

The current discussions surrounding the German health care system are being determined and defined by the concepts of "profitability", "efficiency" and "saving". These concepts also determine the demands made on this system and have had an effect on the medical profession. The economy's growing influence on physicians' decision-making and the increasing necessity to look at and regulate services under economic aspects arising from the need to save costs are seen by the medical profession as a threat to its autonomous conduct and freedom to make decisions, in other words it sees it as a danger to its medical orientation. Conflicts between medical autonomy and economic orientation in physicians' conduct are therefore already foreseeable, as are conflicts between medicine and economy in regards to who has the power to define the terms of the public health system. This article will outline the area of conflict based on the available literature. It will discuss how the political and economic regulatory attempts affect the medical profession's autonomous conduct. It will also discuss which conflicts of conduct emerge for physicians, what types of solutions the medical profession tends to develop as a reaction, and whether or not this tension between medical and economic orientation can be resolved in an acceptable way. This article should first outline the changed economic and political basic conditions and the attempts to reform the German health care system, using this as a starting point. Following this, it will explore the significance professional autonomy acquires within the concept of profession from the point of view of the sociology of professions. With this in mind, the third part of this article will describe and analyze the effects of advanced economization on the medical profession's autonomous conduct, which has long been regarded as uncontested. This part of the article will also describe and analyze the medical profession's strategies it uses to defend

Implementation of a Computerized Screening Inventory: Improved Usability Through Iterative Testing and Modification.

Science.gov (United States)

Boudreaux, Edwin D; Fischer, Andrew Christopher; Haskins, Brianna Lyn; Saeed Zafar, Zubair; Chen, Guanling; Chinai, Sneha A

2016-03-09

The administration of health screeners in a hospital setting has traditionally required (1) clinicians to ask questions and log answers, which can be time consuming and susceptible to error, or (2) patients to complete paper-and-pencil surveys, which require third-party entry of information into the electronic health record and can be vulnerable to error and misinterpretation. A highly promising method that avoids these limitations and bypasses third-party interpretation is direct entry via a computerized inventory. To (1) computerize medical and behavioral health screening for use in general medical settings, (2) optimize patient acceptability and feasibility through iterative usability testing and modification cycles, and (3) examine how age relates to usability. A computerized version of 15 screeners, including behavioral health screeners recommended by a National Institutes of Health Office of Behavioral and Social Sciences Research collaborative workgroup, was subjected to systematic usability testing and iterative modification. Consecutive adult, English-speaking patients seeking treatment in an urban emergency department were enrolled. Acceptability was defined as (1) the percentage of eligible patients who agreed to take the assessment (initiation rate) and (2) average satisfaction with the assessment (satisfaction rate). Feasibility was defined as the percentage of the screening items completed by those who initiated the assessment (completion rate). Chi-square tests, analyses of variance, and Pearson correlations were used to detect whether improvements in initiation, satisfaction, and completion rates were seen over time and to examine the relation between age and outcomes. Of 2157 eligible patients approached, 1280 agreed to complete the screening (initiation rate=59.34%). Statistically significant increases were observed over time in satisfaction (F3,1061=3.35, P=.019) and completion rates (F3,1276=25.44, PUsability testing revealed several critical

Promotion of Problem Solving Skills by Using Metacognitive-based Instruction in Students of Kermanshah University of Medical Sciences

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yahya safari

2017-06-01

Full Text Available Background and objective: Studies have indicated that metacognitive strategies control and direct cognitive strategies. Thus, application of metacognitive and cognitive strategies together is essential for successful learning to happen. The present study was conducted to examine the effect of metacognitive-oriented instruction on development of problem solving skills in students of Kermanshah University of Medical Sciences. Materials and Methods: This study was a quasi-experimental research with pretest/posttest and control group design. The study sample included the students of Kermanshah University of Medical Sciences (n=4283 in the academic year of 2013-2014. A total number of 40 students were selected through convenient sampling method as the study sample. The samples were randomly placed in experimental and control groups. For the experimental group, problem solving skills were taught based on metacognitive strategies in 8 sessions, each session for 1 and half hours. For the control group, however, problem solving skills were taught through conventional teaching method. The instrument for data collection was Heppner’s problem solving inventory (1988 whose validity and reliability were confirmed previously. Data were analyzed by descriptive statistics, mean and standard deviation, and the hypotheses were tested through t-test. Results: The results of the posttest showed that the total mean of scores for problem solving skills in the experimental group (99.75 was higher than that of the control group (26.800 (p<0.0001. This difference was significant in the case of confidence, approach/avoidance and personal control components (p<0.0001. Moreover, the mean of students’ scores was not significant in terms of gender and major. Conclusion: Given the positive effect of metacognitive strategies on the students’ performance and the necessity of teaching metacognition for the sake of academic achievement, these strategies are recommended to be

Validation of diabetes mellitus and hypertension diagnosis in computerized medical records in primary health care

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Abánades-Herranz Juan C

2011-10-01

Full Text Available Abstract Background Computerized Clinical Records, which are incorporated in primary health care practice, have great potential for research. In order to use this information, data quality and reliability must be assessed to prevent compromising the validity of the results. The aim of this study is to validate the diagnosis of hypertension and diabetes mellitus in the computerized clinical records of primary health care, taking the diagnosis criteria established in the most prominently used clinical guidelines as the gold standard against which what measure the sensitivity, specificity, and determine the predictive values. The gold standard for diabetes mellitus was the diagnostic criteria established in 2003 American Diabetes Association Consensus Statement for diabetic subjects. The gold standard for hypertension was the diagnostic criteria established in the Joint National Committee published in 2003. Methods A cross-sectional multicentre validation study of diabetes mellitus and hypertension diagnoses in computerized clinical records of primary health care was carried out. Diagnostic criteria from the most prominently clinical practice guidelines were considered for standard reference. Sensitivity, specificity, positive and negative predictive values, and global agreement (with kappa index, were calculated. Results were shown overall and stratified by sex and age groups. Results The agreement for diabetes mellitus with the reference standard as determined by the guideline was almost perfect (κ = 0.990, with a sensitivity of 99.53%, a specificity of 99.49%, a positive predictive value of 91.23% and a negative predictive value of 99.98%. Hypertension diagnosis showed substantial agreement with the reference standard as determined by the guideline (κ = 0.778, the sensitivity was 85.22%, the specificity 96.95%, the positive predictive value 85.24%, and the negative predictive value was 96.95%. Sensitivity results were worse in patients who

Evaluation of natural language processing from emergency department computerized medical records for intra-hospital syndromic surveillance

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Pagliaroli Véronique

2011-07-01

Full Text Available Abstract Background The identification of patients who pose an epidemic hazard when they are admitted to a health facility plays a role in preventing the risk of hospital acquired infection. An automated clinical decision support system to detect suspected cases, based on the principle of syndromic surveillance, is being developed at the University of Lyon's Hôpital de la Croix-Rousse. This tool will analyse structured data and narrative reports from computerized emergency department (ED medical records. The first step consists of developing an application (UrgIndex which automatically extracts and encodes information found in narrative reports. The purpose of the present article is to describe and evaluate this natural language processing system. Methods Narrative reports have to be pre-processed before utilizing the French-language medical multi-terminology indexer (ECMT for standardized encoding. UrgIndex identifies and excludes syntagmas containing a negation and replaces non-standard terms (abbreviations, acronyms, spelling errors.... Then, the phrases are sent to the ECMT through an Internet connection. The indexer's reply, based on Extensible Markup Language, returns codes and literals corresponding to the concepts found in phrases. UrgIndex filters codes corresponding to suspected infections. Recall is defined as the number of relevant processed medical concepts divided by the number of concepts evaluated (coded manually by the medical epidemiologist. Precision is defined as the number of relevant processed concepts divided by the number of concepts proposed by UrgIndex. Recall and precision were assessed for respiratory and cutaneous syndromes. Results Evaluation of 1,674 processed medical concepts contained in 100 ED medical records (50 for respiratory syndromes and 50 for cutaneous syndromes showed an overall recall of 85.8% (95% CI: 84.1-87.3. Recall varied from 84.5% for respiratory syndromes to 87.0% for cutaneous syndromes. The

Psychometric validation of a new measurement instrument for time-oriented patient information in electronic medical records: A questionnaire survey of physicians.

Science.gov (United States)

Shibuya, Akiko; Misawa, Jimpei; Maeda, Yukihiro; Ichikawa, Rie; Kamata, Michiyo; Inoue, Ryusuke; Morimoto, Tetsuji; Nakayama, Masaharu; Hishiki, Teruyoshi; Kondo, Yoshiaki

2017-12-01

Time is an important element in medical data. Physicians record and store information about patients' disease progress and treatment response in electronic medical records (EMRs). Because EMRs use timestamps, physicians can identify patterns over time regarding a patient's disease and treatment (eg, laboratory values and medications). However, analyses of physicians' use and satisfaction with EMRs have focused on functionality, storage, and system operation rather than the use of time-oriented information. This study aimed to understand physicians' needs regarding time-oriented patient information in EMRs in clinical practice. The reliability and validity of the items in the questionnaire were evaluated in 87 physicians at a national university hospital. Internal consistency was satisfactory (Cronbach alpha coefficient, 0.87). Four dimensions were identified in exploratory factor analysis. Correlations between the 4 dimensions supported the construct validity of the items. Scores of time-oriented patients' medical history in the 4 dimensions showed a significant association with physician age. Based on confirmatory factor analysis, associations were significant and positive (P information in EMRs, both time-oriented treatment results followed by time-oriented team information had significant positive associations. Our study suggests that 4 specific time-oriented patient information factors in EMRs are needed by physicians. Exploring physicians' needs regarding patient-specific time-oriented information may provide a better understanding of the barriers facing the adoption and use of EMRs (eg, decision-making and practice safety concerns) and lead to better acceptance of EMRs in physicians' clinical practices. © 2017 John Wiley & Sons, Ltd.

Improving mathematical problem solving : A computerized approach

NARCIS (Netherlands)

Harskamp, EG; Suhre, CJM

Mathematics teachers often experience difficulties in teaching students to become skilled problem solvers. This paper evaluates the effectiveness of two interactive computer programs for high school mathematics problem solving. Both programs present students with problems accompanied by instruction

Evaluation of problem-based learning in medical students’ education

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MOHAMMAD HADI IMANIEH

2014-01-01

Full Text Available Introduction: In traditional medical education systems much interest is placed on the cramming of basic and clinical facts without considering their applicability in the future professional career. The aim of this study is to evaluate a novice medical training method (problem-based learning as compared to the contemporary teacher-based medical education or traditional methods. Methods: Selection of the study subjects was done through simple sampling and according to the division of medical students introduced from Medical Faculty to the Pediatrics Department with no personal involvement. 120 medical students were assigned to 8 groups of 15 students each. For four months, 4 groups were trained with traditional method and 4 other groups underwent problem-based learning method on selected subject materials. In each method, a pre-course test at the beginning and a post-course test at the end of each course were given to each group. The questionnaire used in this study as the instrument was composed of 39 questions, 37 multiple choice questions and two short answer questions. Three professors of pediatric gastroenterologist took part in the training. Two of these professors were responsible for solving task training method. The third professor used traditional teacher-centered methodology to eliminate any possible bias. Scores obtained from these tests were analyzed using paired t-test and independent t-test. P values of less than 0.05 were considered as significant. Results: The scores of the students undergoing the traditional method were 14.70±3.03 and 21.20±4.07 in the first and second test, respectively. In problembased learning, the scores were 15.82±3.29 in the first and 27.52±4.72 in the second test. There was a significant difference between the mean scores of post-course exams of the two groups (p=0.001, while no significant difference was observed between the mean scores of pre-course exams of the groups (p=0.550. Conclusion: It may be

Development of innovative teaching materials: clinical pharmacology problem-solving (CPPS) units: comparison with patient-oriented problem-solving units and problem-based learning--a 10-year review.

Science.gov (United States)

Lathers, Claire M; Smith, Cedric M

2002-05-01

The First Teaching Clinic in Clinical Pharmacology, sponsored by the American College of Clinical Pharmacology in September 1992, was designed for the preparation and development of new clinical pharmacology problem-solving (CPPS) units. CPPS units are case histories that illustrate pertinent principles in clinical pharmacology. Each unit consists of the following sections: introduction, learning objectives, pretest, four clinical pharmacology scenarios, posttest, answers to pre- and posttest questions, and selected references. The clinical pharmacology content of the CPPS units place greater emphasis on clinical information, drug selection, and risk/benefit analyses, and thus they complement the basic pharmacology presented in the patient-oriented problem-solving (POPS) units. In general, the CPPS units are intended for use by students more advanced in clinical pharmacology than first- and second-year medical students. The CPPS unit "Clinical Pharmacology of Antiepileptic Drug Use: Clinical Pearls about the Perils of Patty" was developed for use by third- and fourth-year medical students doing rotations in neurology or clinical pharmacology; advanced pharmacy students; residents in neurology, pediatrics, internal medicine, and family practice; fellows in clinical pharmacology, and those taking the board examination in clinical pharmacology. The CPPS unit titled "Geriatric Clinical Psychopharmacology" was written for third- and fourth-year medical students; residents in psychiatry, family practice, and internal medicine;fellows in clinical pharmacology; and those studying for boards in clinical pharmacology. The CPPS unit "Anisocoria and Glaucoma" was written for more advanced students of clinical pharmacology. The CPPS unit titled "Antiepileptic Drugs" was intended for second-year medical students. The second teaching clinic was held in November 1993 and focused on the development and editing of the CPPS units and their evaluations by faculty and students from

Compendium to radiation physics for medical physicists. 300 problems and solutions

International Nuclear Information System (INIS)

Podgorsak, Ervin B.

2014-01-01

Can be used in combination with other textbooks. Exercise book for graduate and undergraduate students of medical physics and engineering. Well chosen and didactically presented problems. Perfect set for learning in connection with the textbook by Podgorsak and others. Detailed derivation of results with many detailed illustrations. Fully worked-out solutions to exercises/questions. Combines exercises in radiation physics and medical physics. This exercise book contains 300 typical problems and exercises in modern physics and radiation physics with complete solutions, detailed equations and graphs. This textbook is linked directly with the textbook ''Radiation Physics for Medical Physicists'', Springer (2010) but can also be used in combination with other related textbooks. For ease of use, this textbook has exactly the same organizational layout (14 chapters, 128 sections) as the ''Radiation Physics for Medical Physicists'' textbook and each section is covered by at least one problem with solution given. Equations, figures and tables are cross-referenced between the two books. It is the only large compilation of textbook material and associated solved problems in medical physics, radiation physics, and biophysics.

Psychology of development of moral reasoning: Problem-oriented overview of the field

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Mirić Jovan

2008-01-01

Full Text Available First and foremost, this paper provides a short historical reminder of the emergence of the field of psychology of development of moral reasoning. In the second part of the paper, the author offers a problem-oriented overview of the field, that is, one possible classification of particular groups of problems for empirical research. This overview does not only point out to the problems that were more and that were less studied (e.g.. evaluative moral judgment and reasoning, distinguishing between moral and extra-moral rules and norms and to those that were relatively neglected (i.e. understanding moral situations, but also to the problems that psychologists did not even recognize as research problems. Such are the problems of development of moral concepts, meaning of moral words etc. Finally, the author also points out to the fact that this classification could be taken as one way to define the field, that is, the way to determine the boundaries of its subject of studying.

Problems of radiation protection at medical use of radiation equipment

International Nuclear Information System (INIS)

Larwin, K.

1979-01-01

For medical use of radiation equipment man is not only operator, but also object (patient). The question, if or how much it is necessary to expose the patient, is a medical problem and therefore not to be discussed here. For the user of medical equipments we have often special conditions. For many diagnostic applications the physician has to stay in the application room in contact with the patient. As a typical example for the problems of radiation protection there is discussed the situation on a well known fluoroscopic unit for lung and stomach examinations. (author)

Computerized provider order entry systems.

Science.gov (United States)

2001-01-01

Computerized provider order entry (CPOE) systems are designed to replace a hospital's paper-based ordering system. They allow users to electronically write the full range of orders, maintain an online medication administration record, and review changes made to an order by successive personnel. They also offer safety alerts that are triggered when an unsafe order (such as for a duplicate drug therapy) is entered, as well as clinical decision support to guide caregivers to less expensive alternatives or to choices that better fit established hospital protocols. CPOE systems can, when correctly configured, markedly increase efficiency and improve patient safety and patient care. However, facilities need to recognize that currently available CPOE systems require a tremendous amount of time and effort to be spent in customization before their safety and clinical support features can be effectively implemented. What's more, even after they've been customized, the systems may still allow certain unsafe orders to be entered. Thus, CPOE systems are not currently a quick or easy remedy for medical errors. ECRI's Evaluation of CPOE systems--conducted in collaboration with the Institute for Safe Medication Practices (ISMP)--discusses these and other related issues. It also examines and compares CPOE systems from three suppliers: Eclipsys Corp., IDX Systems Corp., and Siemens Medical Solutions Health Services Corp. Our testing focuses primarily on the systems' interfacing capabilities, patient safeguards, and ease of use.

An Achievement Degree Analysis Approach to Identifying Learning Problems in Object-Oriented Programming

Science.gov (United States)

Allinjawi, Arwa A.; Al-Nuaim, Hana A.; Krause, Paul

2014-01-01

Students often face difficulties while learning object-oriented programming (OOP) concepts. Many papers have presented various assessment methods for diagnosing learning problems to improve the teaching of programming in computer science (CS) higher education. The research presented in this article illustrates that although max-min composition is…

Integrating heterogeneous databases in clustered medic care environments using object-oriented technology

Science.gov (United States)

Thakore, Arun K.; Sauer, Frank

1994-05-01

The organization of modern medical care environments into disease-related clusters, such as a cancer center, a diabetes clinic, etc., has the side-effect of introducing multiple heterogeneous databases, often containing similar information, within the same organization. This heterogeneity fosters incompatibility and prevents the effective sharing of data amongst applications at different sites. Although integration of heterogeneous databases is now feasible, in the medical arena this is often an ad hoc process, not founded on proven database technology or formal methods. In this paper we illustrate the use of a high-level object- oriented semantic association method to model information found in different databases into an integrated conceptual global model that integrates the databases. We provide examples from the medical domain to illustrate an integration approach resulting in a consistent global view, without attacking the autonomy of the underlying databases.

A computerized accountability program is operating - DYMCAS

International Nuclear Information System (INIS)

Combs, S.W.; Mee, W.T.

1983-01-01

The nuclear materials control and accountability program in the Oak Ridge Y-12 Plant has been placed on a computerized system identified as DYMCAS (Dynamic Special Nuclear Materials Control and Accountability System). The primary goal of the DYMCAS is to assist in detecting the diversion of special nuclear material (SNM). Secondly, the system is expected to assure quality inventory reconciliations both under normal and emergency situations. The system has been installed and was placed on active status in April 1982. Since that time numerous problems have surfaced and been resolved; i.e., delays of input, hardware breakdown, and misunderstandings of needs. An explanation of these problems, including examples and alterations that have made the system workable, are presented

ECAT: a new computerized tomographic imaging system for position-emitting radiopharmaceuticals

International Nuclear Information System (INIS)

Phelps, M.E.; Hoffman, E.J.; Huang, S.C.; Kuhl, D.E.

1977-01-01

The ECAT was designed and developed as a complete computerized positron radionuclide imaging system capable of providing high contrast, high resolution, quantitative images in 2 dimensional and tomographic formats. Flexibility, in its various image mode options, allows it to be used for a wide variety of imaging problems

Computerized adaptive testing in computer assisted learning?

NARCIS (Netherlands)

Veldkamp, Bernard P.; Matteucci, Mariagiulia; Eggen, Theodorus Johannes Hendrikus Maria; De Wannemacker, Stefan; Clarebout, Geraldine; De Causmaecker, Patrick

2011-01-01

A major goal in computerized learning systems is to optimize learning, while in computerized adaptive tests (CAT) efficient measurement of the proficiency of students is the main focus. There seems to be a common interest to integrate computerized adaptive item selection in learning systems and

Pre-simulation orientation for medical trainees: An approach to decrease anxiety and improve confidence and performance.

Science.gov (United States)

Bommer, Cassidy; Sullivan, Sarah; Campbell, Krystle; Ahola, Zachary; Agarwal, Suresh; O'Rourke, Ann; Jung, Hee Soo; Gibson, Angela; Leverson, Glen; Liepert, Amy E

2018-02-01

We assessed the effect of basic orientation to the simulation environment on anxiety, confidence, and clinical decision making. Twenty-four graduating medical students participated in a two-week surgery preparatory curriculum, including three simulations. Baseline anxiety was assessed pre-course. Scenarios were completed on day 2 and day 9. Prior to the first simulation, participants were randomly divided into two groups. Only one group received a pre-simulation orientation. Before the second simulation, all students received the same orientation. Learner anxiety was reported immediately preceding and following each simulation. Confidence was assessed post-simulation. Performance was evaluated by surgical faculty. The oriented group experienced decreased anxiety following the first simulation (p = 0.003); the control group did not. Compared to the control group, the oriented group reported less anxiety and greater confidence and received higher performance scores following all three simulations (all p simulation orientation reduces anxiety while increasing confidence and improving performance. Copyright © 2017 Elsevier Inc. All rights reserved.

Between professional autonomy and economic orientation — The medical profession in a changing health care system

Science.gov (United States)

Kälble, Karl

2005-01-01

The current discussions surrounding the German health care system are being determined and defined by the concepts of "profitability", "efficiency" and "saving". These concepts also determine the demands made on this system and have had an effect on the medical profession. The economy's growing influence on physicians' decision-making and the increasing necessity to look at and regulate services under economic aspects arising from the need to save costs are seen by the medical profession as a threat to its autonomous conduct and freedom to make decisions, in other words it sees it as a danger to its medical orientation. Conflicts between medical autonomy and economic orientation in physicians' conduct are therefore already foreseeable, as are conflicts between medicine and economy in regards to who has the power to define the terms of the public health system. Objective: This article will outline the area of conflict based on the available literature. It will discuss how the political and economic regulatory attempts affect the medical profession's autonomous conduct. It will also discuss which conflicts of conduct emerge for physicians, what types of solutions the medical profession tends to develop as a reaction, and whether or not this tension between medical and economic orientation can be resolved in an acceptable way. Methodology: This article should first outline the changed economic and political basic conditions and the attempts to reform the German health care system, using this as a starting point. Following this, it will explore the significance professional autonomy acquires within the concept of profession from the point of view of the sociology of professions. With this in mind, the third part of this article will describe and analyze the effects of advanced economization on the medical profession's autonomous conduct, which has long been regarded as uncontested. This part of the article will also describe and analyze the medical profession

Computerized cognitive training in survivors of childhood cancer: a pilot study.

Science.gov (United States)

Hardy, Kristina K; Willard, Victoria W; Bonner, Melanie J

2011-01-01

The objective of the current study was to pilot a computerized cognitive training program, Captain's Log, in a small sample of survivors of childhood cancer. A total of 9 survivors of acute lymphoblastic leukemia and brain tumors with attention and working memory deficits were enrolled in a home-based 12-week cognitive training program. Survivors returned for follow-up assessments postintervention and 3 months later. The intervention was associated with good feasibility and acceptability. Participants exhibited significant increases in working memory and decreases in parent-rated attention problems following the intervention. Findings indicate that home-based, computerized cognitive intervention is a promising intervention for survivors with cognitive late effects; however, further study is warranted with a larger sample.

Modernizing computerized nuclear material accounting systems

International Nuclear Information System (INIS)

Erkkila, B.H.; Claborn, J.

1995-01-01

DOE Orders and draft orders for nuclear material control and accountability address a complete material control and accountability (MC and A) program for all DOE contractors processing, using, or storing nuclear materials. A critical element of an MC and A program is the accounting system used to track and record all inventories of nuclear material and movements of materials in those inventories. Most DOE facilities use computerized accounting systems to facilitate the task of accounting for all their inventory of nuclear materials. Many facilities still use a mixture of a manual paper system with a computerized system. Also, facilities may use multiple systems to support information needed for MC and A. For real-time accounting it is desirable to implement a single integrated data base management system for a variety of users. In addition to accountability needs, waste management, material management, and production operations must be supported. Information in these systems can also support criticality safety and other safety issues. Modern networked microcomputers provide extensive processing and reporting capabilities that single mainframe computer systems struggle with. This paper describes an approach being developed at Los Alamos to address these problems

Computerization and skill bifurcation: the role of of task complexity in creating skill gains and losses

OpenAIRE

Ben-Ner, Avner; Urtasun Alonso, Ainhoa

2013-01-01

Does computerization increase or reduce the extent of skills that workers are required to have? Autor, Levy and Murnane (2003) show empirically that adoption of computer-based technologies (CBT) was greater in industries historically intensive in routine tasks, and that computerization increased complex problem-solving and communication activities and reduced routine cognitive and manual activities. We extend this argument and argue that the effects of CBT are neither universal nor uniform, b...

Advantages obtained in radiation protection when using computerized radiography tests - CR (digital) in processing plants

International Nuclear Information System (INIS)

Jose, Joao Carlos Videira; Milani, Hilton Sergio B.; Paes, Eliseu Almir de Oliveira; Boita, Mario de; Souza, Laercio de; Serra, Flavio Augusto dos Santos

2002-01-01

During the year 2000, the ARCtest initiated the development of the research for adapting the Computerized Radiography - CR, originally conceived for medical applications, for the Industry, trying initially to attend the requirements of the processing plants, concerning to the detection of deterioration mechanisms (evaluation of the piping integrity). Due to the obtained excellent results, the possibility of utilization the Computerized Radiography - CR in the radiographic inspection were studied during the shutdown of the Catalytic Cracking Unit of the PETROBRAS-REPLAN, specifically in the replacement of the CO boiler superheater, where a large number of the small diameter welded joints have been predicted

Socio-Demographic and Practice-Oriented Factors Related to Proficiency in Problem Solving: A Lifelong Learning Perspective

Science.gov (United States)

Desjardins, Richard; Ederer, Peer

2015-01-01

This article explores the relative importance of different socio-demographic and practice-oriented factors that are related to proficiency in problem solving in technology-rich environments (PSTREs) and by extension may be related to complex problem solving (CPS). The empirical analysis focuses on the proficiency measurements of PSTRE made…

6 Tips to Avoid Medication Mistakes

Science.gov (United States)

... use. Computerized Medication Box FDA has cleared for marketing the Electronic Medication Management Assistant (EMMA), a programmable ... for You Sign up for Consumer Updates by E-mail Page Last Updated: 04/02/2018 Note: If ...

Human Reliability Analysis For Computerized Procedures

International Nuclear Information System (INIS)

Boring, Ronald L.; Gertman, David I.; Le Blanc, Katya

2011-01-01

This paper provides a characterization of human reliability analysis (HRA) issues for computerized procedures in nuclear power plant control rooms. It is beyond the scope of this paper to propose a new HRA approach or to recommend specific methods or refinements to those methods. Rather, this paper provides a review of HRA as applied to traditional paper-based procedures, followed by a discussion of what specific factors should additionally be considered in HRAs for computerized procedures. Performance shaping factors and failure modes unique to computerized procedures are highlighted. Since there is no definitive guide to HRA for paper-based procedures, this paper also serves to clarify the existing guidance on paper-based procedures before delving into the unique aspects of computerized procedures.

The possibilities of applying a risk-oriented approach to the NPP reliability and safety enhancement problem

Science.gov (United States)

Komarov, Yu. A.

2014-10-01

An analysis and some generalizations of approaches to risk assessments are presented. Interconnection between different interpretations of the "risk" notion is shown, and the possibility of applying the fuzzy set theory to risk assessments is demonstrated. A generalized formulation of the risk assessment notion is proposed in applying risk-oriented approaches to the problem of enhancing reliability and safety in nuclear power engineering. The solution of problems using the developed risk-oriented approaches aimed at achieving more reliable and safe operation of NPPs is described. The results of studies aimed at determining the need (advisability) to modernize/replace NPP elements and systems are presented together with the results obtained from elaborating the methodical principles of introducing the repair concept based on the equipment technical state. The possibility of reducing the scope of tests and altering the NPP systems maintenance strategy is substantiated using the risk-oriented approach. A probabilistic model for estimating the validity of boric acid concentration measurements is developed.

Computerized Adaptive Personality Testing: A Review and Illustration With the MMPI-2 Computerized Adaptive Version.

Science.gov (United States)

Forbey, Johnathan D.; Ben-Porath, Yossef S.

2007-01-01

Computerized adaptive testing in personality assessment can improve efficiency by significantly reducing the number of items administered to answer an assessment question. Two approaches have been explored for adaptive testing in computerized personality assessment: item response theory and the countdown method. In this article, the authors…

Complex Problem Solving in Teams: The Impact of Collective Orientation on Team Process Demands.

Science.gov (United States)

Hagemann, Vera; Kluge, Annette

2017-01-01

Complex problem solving is challenging and a high-level cognitive process for individuals. When analyzing complex problem solving in teams, an additional, new dimension has to be considered, as teamwork processes increase the requirements already put on individual team members. After introducing an idealized teamwork process model, that complex problem solving teams pass through, and integrating the relevant teamwork skills for interdependently working teams into the model and combining it with the four kinds of team processes (transition, action, interpersonal, and learning processes), the paper demonstrates the importance of fulfilling team process demands for successful complex problem solving within teams. Therefore, results from a controlled team study within complex situations are presented. The study focused on factors that influence action processes, like coordination, such as emergent states like collective orientation, cohesion, and trust and that dynamically enable effective teamwork in complex situations. Before conducting the experiments, participants were divided by median split into two-person teams with either high ( n = 58) or low ( n = 58) collective orientation values. The study was conducted with the microworld C3Fire, simulating dynamic decision making, and acting in complex situations within a teamwork context. The microworld includes interdependent tasks such as extinguishing forest fires or protecting houses. Two firefighting scenarios had been developed, which takes a maximum of 15 min each. All teams worked on these two scenarios. Coordination within the team and the resulting team performance were calculated based on a log-file analysis. The results show that no relationships between trust and action processes and team performance exist. Likewise, no relationships were found for cohesion. Only collective orientation of team members positively influences team performance in complex environments mediated by action processes such as

Sex-oriented stable matchings of the marriage problem with correlated and incomplete information

Science.gov (United States)

Caldarelli, Guido; Capocci, Andrea; Laureti, Paolo

2001-10-01

In the stable marriage problem two sets of agents must be paired according to mutual preferences, which may happen to conflict. We present two generalizations of its sex-oriented version, aiming to take into account correlations between the preferences of agents and costly information. Their effects are investigated both numerically and analytically.

The academic trend of Oriental Medicine during the Japanese colonial period as observed through the publication of medical books

Directory of Open Access Journals (Sweden)

KIM Nam-il

2006-06-01

Full Text Available This thesis examines the academical trend of Oriental Medicine in the Japanese colonial period observed through medical books published during the Japanese colonial period.This is a period in which Western Medicine was introduced,and due to the lean-to-one-side policy by the Japanese, Western Medicine became the mainstream medical science while Oriental Medicine was pushed to the outskirts.Even after all this,the academic activity was flourishing during this period compared to any other periods. This article is divided into various chapters each with its own theme in order to understand the academic trend of Oriental Medicine during the Japanese colonial period.Focusing on the publication of medical books, this article is divided and observed according to various themes such as the study of Dong-Eui-Bo-Gam(東醫寶鑑,the study of Bang-Yak-Hap- Pyeun(方藥合編,the study of Sang-Han-Ron(傷寒論,the study of Sa-sang (四象constitutional medicine,the study of Eui-Hak-Ip-Mun (醫學入門,the study about Bu-Yang-Ron(扶陽論,On-Bo-Ron(溫補論,and pediatrics, compromise between Western and Oriental Medicine,the study of experience medicine,the study of acupuncture and moxibustion,and etc.

Resetting the compass: exploring the implicit messages of orientation to a community-engaged medical school

Directory of Open Access Journals (Sweden)

Rachel Helen Ellaway

2017-02-01

Conclusion: Orientation to undergraduate medical training can be successfully linked to a school’s social mission, but in doing so it can send complex and unintended messages to the participants that may be perceived quite differently based on their circumstances and expectations.

Compendium to radiation physics for medical physicists 300 problems and solutions

CERN Document Server

Podgorsak, Ervin B

2014-01-01

This exercise book contains 300 typical problems and exercises in modern physics and radiation physics with complete solutions, detailed equations and graphs. This textbook is linked directly with the textbook "Radiation Physics for Medical Physicists", Springer (2010) but can also be used in combination with other related textbooks. For ease of use, this textbook has exactly the same organizational layout (14 chapters, 128 sections) as the "Radiation Physics for Medical Physicists" textbook and each section is covered by at least one problem with solution given. Equations, figures and tables are cross-referenced between the two books. It is the only large compilation of textbook material and associated solved problems in medical physics, radiation physics, and biophysics.

Clinical Approach to the Standardization of Oriental Medical Diagnostic Pattern Identification in Stroke Patients

Directory of Open Access Journals (Sweden)

Han Jung Kim

2011-01-01

Full Text Available In Korea, many stroke patients receive oriental medical care, in which pattern-identification plays a major role. Pattern-identification is Oriental Medicine's unique diagnostic system. This study attempted to standardize oriental medical pattern-identification for stroke patients. This was a community-based multicenter study that enrolled stroke patients within 30 days after their ictus. We assessed the patients' general characteristics and symptoms related to pattern-identification. Each patient's pattern was determined when two doctors had the same opinion. To determine which variables affect the pattern-identification, binary logistic regression analysis was used with the backward method. A total of 806 stroke patients were enrolled. Among 480 patients who were identified as having a certain pattern, 100 patients exhibited the Fire Heat Pattern, 210 patients the Phlegm Dampness Pattern, nine patients the Blood Stasis Pattern, 110 patients the Qi Deficiency Pattern, and 51 patients the Yin Deficiency Pattern. After the regression analysis, the predictive logistic equations for the Fire Heat, Phlegm Dampness, Qi Deficiency, and Yin Deficiency patterns were determined. The Blood Stasis Pattern was omitted because the sample size was too small. Predictive logistic equations were suggested for four of the patterns. These criteria would be useful in determining each stroke patient's pattern in clinics. However, further studies with large samples are necessary to validate and confirm these criteria.

Self-Assessment of Problem Solving Disposition in Medical Students

OpenAIRE

Olivares-Olivares, Silvia Lizett; López-Cabrera, Mildred Vanessa

2014-01-01

Medical schools are committed to both students and society to develop capabilities required to succeed in health care environments. Present diagnosis and treatment methods become obsolete faster, demanding that medical schools incorporate competency-based education to keep pace with future demands. This study was conducted to assess the problem solving disposition of medical students. A three-subcategory model of the skill is proposed. The instrument was validated on content by a group of 17 ...

[Is the ICU staff satisfied with the computerized physician order entry? A cross-sectional survey study].

Science.gov (United States)

Fumis, Renata Rego Lins; Costa, Eduardo Leite Vieira; Martins, Paulo Sergio; Pizzo, Vladimir; Souza, Ivens Augusto; Schettino, Guilherme de Paula Pinto

2014-01-01

To evaluate the satisfaction of the intensive care unit staff with a computerized physician order entry and to compare the concept of the computerized physician order entry relevance among intensive care unit healthcare workers. We performed a cross-sectional survey to assess the satisfaction of the intensive care unit staff with the computerized physician order entry in a 30-bed medical/surgical adult intensive care unit using a self-administered questionnaire. The questions used for grading satisfaction levels were answered according to a numerical scale that ranged from 1 point (low satisfaction) to 10 points (high satisfaction). The majority of the respondents (n=250) were female (66%) between the ages of 30 and 35 years of age (69%). The overall satisfaction with the computerized physician order entry scored 5.74±2.14 points. The satisfaction was lower among physicians (n=42) than among nurses, nurse technicians, respiratory therapists, clinical pharmacists and diet specialists (4.62±1.79 versus 5.97±2.14, phealthcare workers were satisfied, albeit not entirely, with the computerized physician order entry. The overall users' satisfaction with computerized physician order entry was lower among physicians compared to other healthcare professionals. The factors associated with satisfaction included the belief that digitalization decreased the workload and contributed to the intensive care unit quality with a user-friendly and accurate system and that digitalization provided concise information within a reasonable time frame.

ORGANIC PRODUCTION IN UKRAINE: PROBLEMS AND PROSPECTS IN CONTEXT OF SOCIAL ORIENTED ENTEPRENEURSHIP

Directory of Open Access Journals (Sweden)

G. Chornous

2014-06-01

Full Text Available Practical realization of sustainable development general conception is passing to the organic production, that allows to satisfy society problems, not putting health and future generations' existence under a threat. At this entrepreneurs, which work in the consumer products' field, must displace accents from economic oriented to social oriented entrepreneurship. The article is dedicated to research negative and positive factors that influence on social oriented Ukrainian enterprises in the sphere of organic goods production. The special attention is attended to the analysis of foodstuffs producers' activity, the results of which have considerable direct influence on consumers' health. The value of informative influences on consumers and producers is analyzed. State support directions of organic goods production, creation of internal market ecologically safe products infrastructure are defined. Recommendations are given according to research results in relation to stimulation social responsibility of businessmen and model forming, which combines interests of consumers and producers, environmental preservation, population health refinement and ecological situation improvement.

PROBLEMS OF IT DEPARTMENT IN A MEDICAL UNIVERSITY

Directory of Open Access Journals (Sweden)

V. Ya Gelman

2017-01-01

Full Text Available The aim of the study is the analysis of the problems faced by heads and staff of IT departments in medical universities. Methodology and research methods. The methods involve expert estimation, analysis and generalization of practical work experience of IT departments. Results and scientific novelty. The main aspects and specifics of professional activity of IT departments of modern medical schools are designated. The approaches to the definition of the hierarchy of goals in the professional activities of the department, as well as quantitative and qualitative indicators that assess the effectiveness of their achievements are analyzed. The contradictions arising between long-term and short-term goals of the IT department are highlighted. The main challenges which heads of IT departments can deal with in the course of day-to-day management work planning are described. The problems arising in educational, educational-methodical and scientific work of department, in its economic activity, solution of personnel affairs, and aspects of material support are considered. The possible solutions to these problems are proposed. Practical significance. The results of the analysis, proposed approaches and practical recommendations will enable to better organize the work of the IT department in a medical school. The advantage of the proposed approaches consists in their versatility: with some adjustment, they can be used by other departments, regardless of the specifics and the type of educational institution.

Cross-standard user description in mobile, medical oriented virtual collaborative environments

Science.gov (United States)

Ganji, Rama Rao; Mitrea, Mihai; Joveski, Bojan; Chammem, Afef

2015-03-01

By combining four different open standards belonging to the ISO/IEC JTC1/SC29 WG11 (a.k.a. MPEG) and W3C, this paper advances an architecture for mobile, medical oriented virtual collaborative environments. The various users are represented according to MPEG-UD (MPEG User Description) while the security issues are dealt with by deploying the WebID principles. On the server side, irrespective of their elementary types (text, image, video, 3D, …), the medical data are aggregated into hierarchical, interactive multimedia scenes which are alternatively represented into MPEG-4 BiFS or HTML5 standards. This way, each type of content can be optimally encoded according to its particular constraints (semantic, medical practice, network conditions, etc.). The mobile device should ensure only the displaying of the content (inside an MPEG player or an HTML5 browser) and the capturing of the user interaction. The overall architecture is implemented and tested under the framework of the MEDUSA European project, in partnership with medical institutions. The testbed considers a server emulated by a PC and heterogeneous user devices (tablets, smartphones, laptops) running under iOS, Android and Windows operating systems. The connection between the users and the server is alternatively ensured by WiFi and 3G/4G networks.

Medical Imaging with Neural Networks

International Nuclear Information System (INIS)

Pattichis, C.; Cnstantinides, A.

1994-01-01

The objective of this paper is to provide an overview of the recent developments in the use of artificial neural networks in medical imaging. The areas of medical imaging that are covered include : ultrasound, magnetic resonance, nuclear medicine and radiological (including computerized tomography). (authors)

Computerized tomography in diagnosis of cerebrocranial injury

International Nuclear Information System (INIS)

Kornienko, V.N.; Vasin, N.Ya.; Kuz'menko, V.A.

1987-01-01

The method of computerized tomographical examination are presented. Th KT-characters of concussion of the brain, its contusion of different severity, compressions in case of traumatic intracranial hematomas, contusion injuries, brain edema and different aftereffects of cerebrocranial injury are given. On the basis of comparison of the data of clinical and KT examination the dynamics of intracranial traumatic injuries in the course of treatment is described. The problems of therapeutic and surgical tactics depending on the degree and form of intracranial structure injuries and the phase of clinical course of posttraumatic process are discussed

Effect of smartphone overuse on sleep problems in medical students

Directory of Open Access Journals (Sweden)

Pairoj Boonluksiri

2018-05-01

Full Text Available Background: Smartphones are used worldwide. Consequently, it does seem to be having an impact on health-related problems if overused. However, it is uncertain whether it is associated with sleep problems or poor learning. Objective: To determine the association between smartphone overuse and sleep problems in medical students as primary outcome and poor learning as secondary outcome. Methods: A cross-sectional study was conducted in 89 students having their own smartphones, at Hatyai Medical Education Centre, Thailand. The habits of using smartphone were obtained. Smartphone overuse during bedtime was defined as using longer than 1 hour according to Smartphone Addiction Scale (SAS. The primary outcome was napping in a classroom that was defined as a problem if it happened more than 20% of the time attending class. Sleep problems using Pittsburgh Sleep Quality Index (PSQI and Epworth Sleepiness Scale (ESS were obtained by self-assessment. Learning outcome measured by grade point average was the secondary outcome. Multivariable analysis was performed for the association between smartphone overuse and sleep problems. Results: Of all students, 77.5% had sleep problems and 43.6% had napped in the classroom. No personal characteristics, daily life behaviours, and physical environments were associated with sleep problems. 70.8% of all students found to over use smartphones during bedtime. The Facebook website was the most popular. Smartphone overuse was significantly associated with poor sleep quality (odds ratio= 3.46 and napping in the classroom (odds ratio=4.09 but not grade point average. Conclusion: Smartphone overuse during bedtime in medical students is associated with sleep problems but not learning achievement.

Socioeconomic Status, Parenting, and Externalizing Problems in African American Single-Mother Homes: A Person-Oriented Approach

Science.gov (United States)

Anton, Margaret T.; Jones, Deborah J.; Youngstrom, Eric A.

2016-01-01

African American youth, particularly those from single-mother homes, are overrepresented in statistics on externalizing problems. The family is a central context in which to understand externalizing problems; however, reliance on variable-oriented approaches to the study of parenting, which originate from work with intact, middle-income, European American families, may obscure important information regarding variability in parenting styles among African American single mothers, and in turn, variability in youth outcomes as well. The current study demonstrated that within African American single-mother families: (a) a person-, rather than variable-, oriented approach to measuring parenting style may further elucidate variability; (b) socioeconomic status may provide 1 context within which to understanding variability in parenting style; and (c) 1 marker of socioeconomic status, income, and parenting style may each explain variability in youth externalizing problems; however, the interaction between income and parenting style was not significant. Findings have potential implications for better understanding the specific contexts in which externalizing problems may be most likely to occur within this at-risk and underserved group. PMID:26053349

Socioeconomic status, parenting, and externalizing problems in African American single-mother homes: A person-oriented approach.

Science.gov (United States)

Anton, Margaret T; Jones, Deborah J; Youngstrom, Eric A

2015-06-01

African American youth, particularly those from single-mother homes, are overrepresented in statistics on externalizing problems. The family is a central context in which to understand externalizing problems; however, reliance on variable-oriented approaches to the study of parenting, which originate from work with intact, middle-income, European American families, may obscure important information regarding variability in parenting styles among African American single mothers, and in turn, variability in youth outcomes as well. The current study demonstrated that within African American single-mother families: (a) a person-, rather than variable-, oriented approach to measuring parenting style may further elucidate variability; (b) socioeconomic status may provide 1 context within which to understanding variability in parenting style; and (c) 1 marker of socioeconomic status, income, and parenting style may each explain variability in youth externalizing problems; however, the interaction between income and parenting style was not significant. Findings have potential implications for better understanding the specific contexts in which externalizing problems may be most likely to occur within this at-risk and underserved group. (c) 2015 APA, all rights reserved).

A novel computerized surgeon-machine interface for robot-assisted laser phonomicrosurgery.

Science.gov (United States)

Mattos, Leonardo S; Deshpande, Nikhil; Barresi, Giacinto; Guastini, Luca; Peretti, Giorgio

2014-08-01

To introduce a novel computerized surgical system for improved usability, intuitiveness, accuracy, and controllability in robot-assisted laser phonomicrosurgery. Pilot technology assessment. The novel system was developed involving a newly designed motorized laser micromanipulator, a touch-screen display, and a graphics stylus. The system allows the control of a CO2 laser through interaction between the stylus and the live video of the surgical area. This empowers the stylus with the ability to have actual effect on the surgical site. Surgical enhancements afforded by this system were established through a pilot technology assessment using randomized trials comparing its performance with a state-of-the-art laser microsurgery system. Resident surgeons and medical students were chosen as subjects in performing sets of trajectory-following exercises. Image processing-based techniques were used for an objective performance assessment. A System Usability Scale-based questionnaire was used for the qualitative assessment. The computerized interface demonstrated superiority in usability, accuracy, and controllability over the state-of-the-art system. Significant ease of use and learning experienced by the subjects were demonstrated by the usability score assigned to the two compared interfaces: computerized interface = 83.96% versus state-of-the-art = 68.02%. The objective analysis showed a significant enhancement in accuracy and controllability: computerized interface = 90.02% versus state-of-the-art = 75.59%. The novel system significantly enhances the accuracy, usability, and controllability in laser phonomicrosurgery. The design provides an opportunity to improve the ergonomics and safety of current surgical setups. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

Child and caregiver reported problems in using asthma medications and question-asking during paediatric asthma visits.

Science.gov (United States)

Sleath, Betsy; Carpenter, Delesha M; Beard, Ashley; Gillette, Christopher; Williams, Dennis; Tudor, Gail; Ayala, Guadalupe X

2014-02-01

The objectives of the study were to describe the extent to which lay caregivers and children who reported asthma medication problems asked medication questions during their medical visits. Children with asthma ages 8 through 16 years and their caregivers were recruited at five paediatric practices and their medical visits were audiotape recorded. Children were interviewed after their medical visits and caregivers completed questionnaires. A home visit was conducted 1 month later. Generalized estimating equations were used to analyse the data. Two hundred and ninety six families participated. Among those caregivers who reported asthma medication problems, only 35% had asked at least one medication question during the visit. Among children who reported asthma medication problems, only 11% had asked at least one medication question during their consultation. Caregivers and children who reported a problem with their asthma medications were significantly more likely to have asked medication questions if providers had asked more questions about control medications. Children who reported higher asthma management self-efficacy were significantly more likely to have asked an asthma medication question. Only one in three caregivers and one in 10 children who reported an asthma medication problem asked a question during their medical visits and many still reported these problems 1 month later. Pharmacists should encourage caregivers and children to report problems they may be having using their asthma medications. © 2013 Royal Pharmaceutical Society.

Formal Verification of Computerized Procedure with Colored Petri Nets

International Nuclear Information System (INIS)

Kim, Yun Goo; Shin, Yeong Cheol

2008-01-01

Computerized Procedure System (CPS) supports nuclear power plant operators in performing operating procedures which are instructions to guide in monitoring, decision making and controlling nuclear power plants. Computerized Procedure (CP) should be loaded to CPS. Due to its execution characteristic, computerized procedure acts like a software in CPS. For example, procedure flows are determined by operator evaluation and computerized procedure logic which are pre-defined. So the verification of Computerized Procedure logic and execution flow is needed before computerized procedures are installed in the system. Formal verification methods are proposed and the modeling of operating procedures with Coloured Petri Nets(CP-nets) is presented

Computerized Decision Aids for Shared Decision Making in Serious Illness: Systematic Review.

Science.gov (United States)

Staszewska, Anna; Zaki, Pearl; Lee, Joon

2017-10-06

Shared decision making (SDM) is important in achieving patient-centered care. SDM tools such as decision aids are intended to inform the patient. When used to assist in decision making between treatments, decision aids have been shown to reduce decisional conflict, increase ease of decision making, and increase modification of previous decisions. The purpose of this systematic review is to assess the impact of computerized decision aids on patient-centered outcomes related to SDM for seriously ill patients. PubMed and Scopus databases were searched to identify randomized controlled trials (RCTs) that assessed the impact of computerized decision aids on patient-centered outcomes and SDM in serious illness. Six RCTs were identified and data were extracted on study population, design, and results. Risk of bias was assessed by a modified Cochrane Risk of Bias Tool for Quality Assessment of Randomized Controlled Trials. Six RCTs tested decision tools in varying serious illnesses. Three studies compared different computerized decision aids against each other and a control. All but one study demonstrated improvement in at least one patient-centered outcome. Computerized decision tools may reduce unnecessary treatment in patients with low disease severity in comparison with informational pamphlets. Additionally, electronic health record (EHR) portals may provide the opportunity to manage care from the home for individuals affected by illness. The quality of decision aids is of great importance. Furthermore, satisfaction with the use of tools is associated with increased patient satisfaction and reduced decisional conflict. Finally, patients may benefit from computerized decision tools without the need for increased physician involvement. Most computerized decision aids improved at least one patient-centered outcome. All RCTs identified were at a High Risk of Bias or Unclear Risk of Bias. Effort should be made to improve the quality of RCTs testing SDM aids in serious

Technologies in computerized lexicography | Kruyt | Lexikos

African Journals Online (AJOL)

Although the topic of this paper is technology, focus is on functional rather than technical aspects of computerized lexicography. Keywords: computerized lexicography, electronic dictionary, electronic text corpus, lexicographer's workbench, integrated language database, automatic linguistic analysis, information retrieval, ...

Self-reported competency ratings of graduates of a problem-leased medical curriculum

NARCIS (Netherlands)

van der Molen, H. T.

Purpose. To study the self-reports of professional competencies by graduates of a problem-based medical curriculum. Method. All graduates from a medical school and a faculty of health sciences with a problem-based curriculum were sent a questionnaire asking them to compare their own performances in

Self-reported competency ratings of graduates of a problem-based medical curriculum

NARCIS (Netherlands)

H.G. Schmidt (Henk); H.M. van der Molen

2001-01-01

textabstractPurpose. To study the self-reports of professional competencies by graduates of a problem-based medical curriculum. Method. All graduates from a medical school and a faculty of health sciences with a problem-based curriculum were sent a questionnaire asking them to compare their own

Nurses' perceptions and problems in the usability of a medication safety app.

Science.gov (United States)

Ankem, Kalyani; Cho, Sookyung; Simpson, Diana

2017-10-16

The majority of medication apps support medication adherence. Equally, if not more important, is medication safety. Few apps report on medication safety, and fewer studies have been conducted with these apps. The usability of a medication safety app was tested with nurses to reveal their perceptions of the graphical user interface and to discover problems they encountered in using the app. Usability testing of the app was conducted with RN-BSN students and informatics students (n = 18). Perceptions of the graphical components were gathered in pretest and posttest questionnaires, and video recordings of the usability testing were transcribed. The significance of the difference in mean performance time for 8 tasks was tested, and qualitative analysis was deployed to identify problems encountered and to rate the severity of each problem. While all participants perceived the graphical user interface as easy to understand, nurses took significantly more time to complete certain tasks. More nurses found the medication app to be lacking in intuitiveness of user interface design, in capability to match real-world data, and in providing optimal information architecture. To successfully integrate mobile devices in healthcare, developers must address the problems that nurses encountered in use of the app.

Computerized Tests. New practical and ethical challenges for Psychological Assessment

Directory of Open Access Journals (Sweden)

Gabriela Susana Lozzia

2013-08-01

Full Text Available The purpose of this study is to bring the readers in our field of knowledge closer to the new problems and solutions resulting from the application of computer systems to Psychological Assessment. Therefore, this work puts forward a suitable implementation of Computer-based and Internet-delivered Testing, includes a description of the new technologies that can be applied to Psychological Assessment: administration of traditional paper-and-pencil tests through computers, elaboration of automated reports, computerized adaptive tests, automated test construction and automatic generation of items, as well as the specific guidelines and regulations governing the development of each of these areas. This study provides an outline of the current issues connected with the appropriate use of Computerized Tests by way of conclusion and finally encourages psychologists to keep debating and reflecting on these topics.

39 CFR 501.15 - Computerized Meter Resetting System.

Science.gov (United States)

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Computerized Meter Resetting System. 501.15... AND DISTRIBUTE POSTAGE EVIDENCING SYSTEMS § 501.15 Computerized Meter Resetting System. (a) Description. The Computerized Meter Resetting System (CMRS) permits customers to reset their postage meters at...

Bladder Control Problems: Medications for Treating Urinary Incontinence

Science.gov (United States)

... control problems, including how they work to treat urinary incontinence and possible side effects. By Mayo Clinic Staff ... a look at medications commonly prescribed to treat urinary incontinence and their possible side effects. Keep in mind ...

Students' Performance Awareness, Motivational Orientations and Learning Strategies in a Problem-Based Electromagnetism Course

Science.gov (United States)

Saglam, Murat

2010-01-01

This study aims to explore problem-based learning (PBL) in conjunction with students' confidence in the basic ideas of electromagnetism and their motivational orientations and learning strategies. The 78 first-year geology and geophysics students followed a three-week PBL instruction in electromagnetism. The students' confidence was assessed…

Parallel Object-Oriented Computation Applied to a Finite Element Problem

Directory of Open Access Journals (Sweden)

Jon B. Weissman

1993-01-01

Full Text Available The conventional wisdom in the scientific computing community is that the best way to solve large-scale numerically intensive scientific problems on today's parallel MIMD computers is to use Fortran or C programmed in a data-parallel style using low-level message-passing primitives. This approach inevitably leads to nonportable codes and extensive development time, and restricts parallel programming to the domain of the expert programmer. We believe that these problems are not inherent to parallel computing but are the result of the programming tools used. We will show that comparable performance can be achieved with little effort if better tools that present higher level abstractions are used. The vehicle for our demonstration is a 2D electromagnetic finite element scattering code we have implemented in Mentat, an object-oriented parallel processing system. We briefly describe the application. Mentat, the implementation, and present performance results for both a Mentat and a hand-coded parallel Fortran version.

Electronic health record training in undergraduate medical education: bridging theory to practice with curricula for empowering patient- and relationship-centered care in the computerized setting.

Science.gov (United States)

Wald, Hedy S; George, Paul; Reis, Shmuel P; Taylor, Julie Scott

2014-03-01

While electronic health record (EHR) use is becoming state-of-the-art, deliberate teaching of health care information technology (HCIT) competencies is not keeping pace with burgeoning use. Medical students require training to become skilled users of HCIT, but formal pedagogy within undergraduate medical education (UME) is sparse. How can medical educators best meet the needs of learners while integrating EHRs into medical education and practice? How can they help learners preserve and foster effective communication skills within the computerized setting? In general, how can UME curricula be devised for skilled use of EHRs to enhance rather than hinder provision of effective, humanistic health care?Within this Perspective, the authors build on recent publications that "set the stage" for next steps: EHR curricula innovation and implementation as concrete embodiments of theoretical underpinnings. They elaborate on previous calls for maximizing benefits and minimizing risks of EHR use with sufficient focus on physician-patient communication skills and for developing core competencies within medical education. The authors describe bridging theory into practice with systematic longitudinal curriculum development for EHR training in UME at their institution, informed by Kern and colleagues' curriculum development framework, narrative medicine, and reflective practice. They consider this innovation within a broader perspective-the overarching goal of empowering undergraduate medical students' patient- and relationship-centered skills while effectively demonstrating HCIT-related skills.

Orientation leaflet for radiological and nuclear medical examinations. Recommendations of the Radiation Protection Commission (SSK)

International Nuclear Information System (INIS)

Gumprecht, D.; Haehnel, S.; Hahn, C.; Heller, H.

2006-01-01

The brochure is to help doctors in hospitals as well as private practitioners to select the best suited examination procedures for a given problem and help them to take better care of their patients and reduce their radiation exposure. The criteria are no substitute for the indication required by Section 80 of the Radiation Protection Ordinance and Section 23 of the X-Ray Ordinance, i.e. e. an indication in which the health effect surpasses the health risk resulting from radiation exposure. The brochure informs on the role of X-ray examinations, ultrasonic examinations, computerized tomography, magnetic resonance tomography, nuclear medicine, positron emission tomography and interventional examinations in given cases. The body system approach used in the EU version was retained. (orig.)

Understanding catastrophizing from a misdirected problem-solving perspective.

Science.gov (United States)

Flink, Ida K; Boersma, Katja; MacDonald, Shane; Linton, Steven J

2012-05-01

The aim is to explore pain catastrophizing from a problem-solving perspective. The links between catastrophizing, problem framing, and problem-solving behaviour are examined through two possible models of mediation as inferred by two contemporary and complementary theoretical models, the misdirected problem solving model (Eccleston & Crombez, 2007) and the fear-anxiety-avoidance model (Asmundson, Norton, & Vlaeyen, 2004). In this prospective study, a general population sample (n= 173) with perceived problems with spinal pain filled out questionnaires twice; catastrophizing and problem framing were assessed on the first occasion and health care seeking (as a proxy for medically oriented problem solving) was assessed 7 months later. Two different approaches were used to explore whether the data supported any of the proposed models of mediation. First, multiple regressions were used according to traditional recommendations for mediation analyses. Second, a bootstrapping method (n= 1000 bootstrap resamples) was used to explore the significance of the indirect effects in both possible models of mediation. The results verified the concepts included in the misdirected problem solving model. However, the direction of the relations was more in line with the fear-anxiety-avoidance model. More specifically, the mediation analyses provided support for viewing catastrophizing as a mediator of the relation between biomedical problem framing and medically oriented problem-solving behaviour. These findings provide support for viewing catastrophizing from a problem-solving perspective and imply a need to examine and address problem framing and catastrophizing in back pain patients. ©2011 The British Psychological Society.

Patient surface doses in computerized tomography examinations

International Nuclear Information System (INIS)

Vekic, B; Kovacevic, S.; Ranogajec-Komor, M.; Duvnjak, N.; Marusic, P.; Anic, P.; Dolencic, P.

1996-01-01

The diagnostic value of computerized tomography has increased due to very rapid technical advances in both equipment and techniques. When the CT scanners were introduced, a significant problem for the specification of the radiation dose imparted to the patient undergoing CT examination has been created. In CT, the conditions of exposure are quite different from those in conventional X-ray imaging. CT procedure involves the continuous tomography of thin layers. Some of these layers touch each other while others overlap. The radiation doses received by patients can vary considerably. In addition to the radiation from the collimated primary beam, patients are exposed to significant scattered doses in unpredictable amounts. Every effort should be made to keep these doses to a reasonable minimum, without sacrificing the image quality. The aims of this work were to determine the surface doses delivered to various organs of patients during various computerized tomography examinations (head, thorax, kidney, abdomen and pelvis). Particular attention was directed to the precise determination of doses received by the eyes (during CT of head) and gonads (during CT of pelvis and lower abdomen) since these organs can be near or even in the primary X-ray beam

An analytic approach to resolving problems in medical ethics.

OpenAIRE

Candee, D; Puka, B

1984-01-01

Education in ethics among practising professionals should provide a systematic procedure for resolving moral problems. A method for such decision-making is outlined using the two classical orientations in moral philosophy, teleology and deontology. Teleological views such as utilitarianism resolve moral dilemmas by calculating the excess of good over harm expected to be produced by each feasible alternative for action. The deontological view focuses on rights, duties, and principles of justic...

Medical Imaging with Neural Networks

Energy Technology Data Exchange (ETDEWEB)

Pattichis, C [Department of Computer Science, University of Cyprus, Kallipoleos 75, P.O.Box 537, Nicosia (Cyprus); Cnstantinides, A [Department of Electrical Engineering, Imperial College of Science, Technology and Medicine, London SW7 2BT (United Kingdom)

1994-12-31

The objective of this paper is to provide an overview of the recent developments in the use of artificial neural networks in medical imaging. The areas of medical imaging that are covered include : ultrasound, magnetic resonance, nuclear medicine and radiological (including computerized tomography). (authors). 61 refs, 4 tabs.

Medical audit on problem analysis and implementing changes at the ...

African Journals Online (AJOL)

Infection control and continuing medical education committees were formed where they did not exist. Conclusion/Recommendation: Hospital medical audit on problem analysis and implementation of changes in health units is highly effective in stimulating and empowering health care workers and hospital administrators to ...

Principles of medical imaging with emphasis on tomography

Energy Technology Data Exchange (ETDEWEB)

Kouris, K [Institute of Nuclear Medicine, University College, London Medical School, Mortimer Street, London W1N 8AA (United Kingdom)

1994-12-31

Medical imaging with ionizing and non-ionizing radiations belongs to the class of problems known as indirect sensing. This article is concerned with imaging methods known as image reconstruction from projections or computerized tomography. A brief comparative study of the theory is presented. Depending on the nature and modes of propagation of the employed radiation, methods are discussed either under transmission tomography (with gamma rays and X rays) or emission tomography (with gamma rays and positrons). Magnetic resonance Imaging (MRI) is described as resonant absorption and re-emission of radiofrequency energy. (author). 6 refs, 1 fig.

Unintended Transformations of Clinical Relations with a Computerized Physician Order Entry System

DEFF Research Database (Denmark)

Wentzer, Helle; Böttger, Ulrich; Boye, Niels

2007-01-01

A socio-technical approach was used to study the qualitative effects of deploying a medication CPOE (Computerized Physician Order Entry System with no decision support) at two internal medical wards in a hospital in Denmark. Our results show spatial and temporal transformations of core acts...... and relations in medication work, i.e. of the intended use of the system inscribed in hardware and software, in the relations of care between doctors and patients, of collaboration between doctors and nurses, and prospectively of the patients’ trajectories when readmitted to hospital or another health care...... or ‘doing medication’. The paper argues for the project organization to support the local collaboration and renegotiation of time and place of enacting medication with CPOE, as well as set up feedback for maturation of the software for future clinical use....

Revisiting the medical diagnosis problem

DEFF Research Database (Denmark)

Ejersbo, Lisser Rye; Leron, Uri

2014-01-01

in the context of probability, with special focus on one case study – the Medical Diagnosis Problem – which figures prominently in the cognitive psychology research literature and in the so-called rationality debate. Our case study involves a combination of theory, design and experiment: Using the extensive...... psychological research as a theoretical base, we design a new “bridging” task, which is on the one hand formally equivalent to the given “difficult” task, but on the other hand is much more accessible to students’ intuitions. Furthermore, this new task would serve as "stepping stone", enabling students to solve...

The Impact of CPOE Medication Systems' Design Aspects on Usability, Workflow and Medication Orders A Systematic Review

NARCIS (Netherlands)

Khajouei, R.; Jaspers, M. W. M.

2010-01-01

Objectives: To examine the impact of design aspects of computerized physician order entry (CPOE) systems for medication ordering on usability, physicians' workflow and on medication orders. Methods: We systematically searched Pub-Med, EMBASE and Ovid MEDLINE for articles published from 1986 to 2007.

Medical problems of survivors of nuclear war

International Nuclear Information System (INIS)

Abrams, H.L.; Von Kaenel, W.E.

1981-01-01

The nature of the medical problems that may confront survivors of a nuclear war are discussed with emphasis on infection and the spread of communicable disease. Factors which will increase the risk and severity of infection include: radiation, trauma and burns, malnutrition and starvation, dehydration, exposure, and hardship. Factors which will increase the spread of disease include: crowded shelter conditions, poor sanitation, insects, corpses, free-roaming diseased animals. Shortages of physicians, the destruction of laboratories, and the general disorganization sure to follow the attack will also contribute to the problems. The authors recommend further study in this area

Microcomputer Network for Computerized Adaptive Testing (CAT)

Science.gov (United States)

1984-03-01

PRDC TR 84-33 \\Q.�d-33- \\ MICROCOMPUTER NETWOJlt FOR COMPUTERIZED ADAPTIVE TESTING ( CAT ) Baldwin Quan Thomas A . Park Gary Sandahl John H...ACCEIIION NO NPRDC TR 84-33 4. TITLE (-d Sul>tlllo) MICROCOMP UTER NETWORK FOR COMPUTERIZED ADA PTIVE TESTING ( CAT ) 1. Q B. uan T. A . Park...adaptive testing ( CAT ) Bayesian sequential testing 20. ABSTitACT (Continuo on ro•••• aide II noco .. _, _., ld-tlly ,.,. t.loclt _._.) DO Computerized

Complex Problem Solving in Teams: The Impact of Collective Orientation on Team Process Demands

Science.gov (United States)

Hagemann, Vera; Kluge, Annette

2017-01-01

Complex problem solving is challenging and a high-level cognitive process for individuals. When analyzing complex problem solving in teams, an additional, new dimension has to be considered, as teamwork processes increase the requirements already put on individual team members. After introducing an idealized teamwork process model, that complex problem solving teams pass through, and integrating the relevant teamwork skills for interdependently working teams into the model and combining it with the four kinds of team processes (transition, action, interpersonal, and learning processes), the paper demonstrates the importance of fulfilling team process demands for successful complex problem solving within teams. Therefore, results from a controlled team study within complex situations are presented. The study focused on factors that influence action processes, like coordination, such as emergent states like collective orientation, cohesion, and trust and that dynamically enable effective teamwork in complex situations. Before conducting the experiments, participants were divided by median split into two-person teams with either high (n = 58) or low (n = 58) collective orientation values. The study was conducted with the microworld C3Fire, simulating dynamic decision making, and acting in complex situations within a teamwork context. The microworld includes interdependent tasks such as extinguishing forest fires or protecting houses. Two firefighting scenarios had been developed, which takes a maximum of 15 min each. All teams worked on these two scenarios. Coordination within the team and the resulting team performance were calculated based on a log-file analysis. The results show that no relationships between trust and action processes and team performance exist. Likewise, no relationships were found for cohesion. Only collective orientation of team members positively influences team performance in complex environments mediated by action processes such as

Complex Problem Solving in Teams: The Impact of Collective Orientation on Team Process Demands

Directory of Open Access Journals (Sweden)

Vera Hagemann

2017-09-01

Full Text Available Complex problem solving is challenging and a high-level cognitive process for individuals. When analyzing complex problem solving in teams, an additional, new dimension has to be considered, as teamwork processes increase the requirements already put on individual team members. After introducing an idealized teamwork process model, that complex problem solving teams pass through, and integrating the relevant teamwork skills for interdependently working teams into the model and combining it with the four kinds of team processes (transition, action, interpersonal, and learning processes, the paper demonstrates the importance of fulfilling team process demands for successful complex problem solving within teams. Therefore, results from a controlled team study within complex situations are presented. The study focused on factors that influence action processes, like coordination, such as emergent states like collective orientation, cohesion, and trust and that dynamically enable effective teamwork in complex situations. Before conducting the experiments, participants were divided by median split into two-person teams with either high (n = 58 or low (n = 58 collective orientation values. The study was conducted with the microworld C3Fire, simulating dynamic decision making, and acting in complex situations within a teamwork context. The microworld includes interdependent tasks such as extinguishing forest fires or protecting houses. Two firefighting scenarios had been developed, which takes a maximum of 15 min each. All teams worked on these two scenarios. Coordination within the team and the resulting team performance were calculated based on a log-file analysis. The results show that no relationships between trust and action processes and team performance exist. Likewise, no relationships were found for cohesion. Only collective orientation of team members positively influences team performance in complex environments mediated by action processes

Computerized tomography in the diagnosis of mechanical jaundice

International Nuclear Information System (INIS)

Grushin, Yu.V.; Manasov, T.Zh.; Raskolenko, A.A.; Nazyrova, N.K.; Dzhumashev, E.Z.

1987-01-01

A total of 51 patients with suspected mechanical jaundice were examined using the 3rd generation computerized tomograph. A correct conclusion as to the level and mechanism of obstruction was made in 77% of cases. The most serious problems arose in analysis of extrahepatic biliary ducts. The dilatation of the biliary passages was not always combined with their obturation. In cases which were difficult for interpretation, additional information could be obtained by using thin tomographic layers, i.v. contrast enhancement, and retrograde endoscopic cholangiography

Post-hoc simulation study to adopt a computerized adaptive testing (CAT) for a Korean Medical License Examination.

Science.gov (United States)

Seo, Dong Gi; Choi, Jeongwook

2018-05-17

Computerized adaptive testing (CAT) has been adopted in license examinations due to a test efficiency and accuracy. Many research about CAT have been published to prove the efficiency and accuracy of measurement. This simulation study investigated scoring method and item selection methods to implement CAT in Korean medical license examination (KMLE). This study used post-hoc (real data) simulation design. The item bank used in this study was designed with all items in a 2017 KMLE. All CAT algorithms for this study were implemented by a 'catR' package in R program. In terms of accuracy, Rasch and 2parametric logistic (PL) model performed better than 3PL model. Modal a Posteriori (MAP) or Expected a Posterior (EAP) provided more accurate estimates than MLE and WLE. Furthermore Maximum posterior weighted information (MPWI) or Minimum expected posterior variance (MEPV) performed better than other item selection methods. In terms of efficiency, Rasch model was recommended to reduce test length. Simulation study should be performed under varied test conditions before adopting a live CAT. Based on a simulation study, specific scoring and item selection methods should be predetermined before implementing a live CAT.

Medical-isotope supply hit by production problems

Science.gov (United States)

Gould, Paula

2008-10-01

A shortfall in the production of medical isotopes in Europe has forced hospitals to delay patient scans or offer alternative diagnostic tests. The problems began in August when all three nuclear reactors used to generate molybdenum-99, which then decays to form the key nuclear-imaging agent technetium-99, had to be unexpectedly shut down at the same time.

A renewed Medication Adherence Alliance call to action: harnessing momentum to address medication nonadherence in the United States.

Science.gov (United States)

Zullig, Leah L; Granger, Bradi B; Bosworth, Hayden B

2016-01-01

Nonadherence to prescription medications is a common and costly problem with multiple contributing factors, spanning the dimensions of individual behavior change, psychology, medicine, and health policy, among others. Addressing the problem of medication nonadherence requires strategic input from key experts in a number of fields. The Medication Adherence Alliance is a group of key experts, predominately from the US, in the field of medication nonadherence. Members include representatives from consumer advocacy groups, community health providers, nonprofit groups, the academic community, decision-making government officials, and industry. In 2015, the Medication Adherence Alliance convened to review the current landscape of medication adherence. The group then established three working groups that will develop recommendations for shifting toward solutions-oriented science. From the perspective of the Medication Adherence Alliance, the objective of this commentary is to describe changes in the US landscape of medication adherence, framing the evolving field in the context of a recent think tank meeting of experts in the field of medication adherence.

Computerized system for measuring cerebral metabolism

International Nuclear Information System (INIS)

McGlone, J.S.; Hibbard, L.S.; Hawkins, R.A.; Kasturi, R.

1987-01-01

A computerized stereotactic measurement system for evaluating rat brain metabolism was developed to utilize the large amount of data generated by quantitative autoradiography. Conventional methods of measurement only analyze a small percent of these data because these methods are limited by instrument design and the subjectiveness of the investigator. However, a computerized system allows digital images to be analyzed by placing data at their appropriate three-dimensional stereotactic coordinates. The system automatically registers experimental data to a standard three-dimensional image using alignment, scaling, and matching operations. Metabolic activity in different neuronal structures is then measured by generating digital masks and superimposing them on to experimental data. Several experimental data sets were evaluated and it was noticed that the structures measured by the computerized system, had in general, lower metabolic activity than manual measurements had indicated. This was expected because the computerized system measured the structure over its volume while the manual readings were taken from the most active metabolic area of a particular structure

Efficient Metaheuristics for the Mixed Team Orienteering Problem with Time Windows

Directory of Open Access Journals (Sweden)

Damianos Gavalas

2016-01-01

Full Text Available Given a graph whose nodes and edges are associated with a profit, a visiting (or traversing time and an admittance time window, the Mixed Team Orienteering Problem with Time Windows (MTOPTW seeks for a specific number of walks spanning a subset of nodes and edges of the graph so as to maximize the overall collected profit. The visit of the included nodes and edges should take place within their respective time window and the overall duration of each walk should be below a certain threshold. In this paper we introduce the MTOPTW, which can be used for modeling a realistic variant of the Tourist Trip Design Problem where the objective is the derivation of near-optimal multiple-day itineraries for tourists visiting a destination which features several points of interest (POIs and scenic routes. Since the MTOPTW is a NP-hard problem, we propose the first metaheuristic approaches to tackle it. The effectiveness of our algorithms is validated through a number of experiments on POI and scenic route sets compiled from the city of Athens (Greece.

A basic framework for the analysis of the human error potential due to the computerization in nuclear power plants

International Nuclear Information System (INIS)

Lee, Y. H.

1999-01-01

Computerization and its vivid benefits expected in the nuclear power plant design cannot be realized without verifying the inherent safety problems. Human error aspect is also included in the verification issues. The verification spans from the perception of the changes in operation functions such as automation to the unfamiliar experience of operators due to the interface change. Therefore, a new framework for human error analysis might capture both the positive and the negative effect of the computerization. This paper suggest a basic framework for error identification through the review of the existing human error studies and the experience of computerizations in nuclear power plants

Mechatronic Control Engineering: A Problem Oriented And Project Based Learning Curriculum In Mechatronic

DEFF Research Database (Denmark)

Pedersen, Henrik Clemmensen; Andersen, Torben Ole; Hansen, Michael Rygaard

2008-01-01

Mechatronics is a field of multidisciplinary engineering that not only requires knowledge about different technical areas, but also insight into how to combine technologies optimally, to design efficient products and systems.This paper addresses the group project based and problem-oriented learning...... the well established methods from control engineering form very powerful techniques in both analysis and synthesis of mechatronic systems. The necessary skills for mechatronic engineers are outlined followed up by a discussion on how problem oriented project based learning is implemented. A complete...... curriculum named Mechatronic Control Engineering is presented, which is started at Aalborg University, Denmark, and the content of the semesters and projects are described. The projects are all characterized by the use of simulation and control for the purpose of analyzing and designing complex commercial...

Information on actual medication use and drug-related problems in older patients: questionnaire or interview?

Science.gov (United States)

Willeboordse, Floor; Grundeken, Lucienne H; van den Eijkel, Lisanne P; Schellevis, François G; Elders, Petra J M; Hugtenburg, Jacqueline G

2016-04-01

Information on medication use and drug-related problems is important in the preparation of clinical medication reviews. Critical information can only be provided by patients themselves, but interviewing patients is time-consuming. Alternatively, patient information could be obtained with a questionnaire. In this study the agreement between patient information on medication use and drug-related problems in older patients obtained with a questionnaire was compared with information obtained during an interview. General practice in The Netherlands. A questionnaire was developed to obtain information on actual medication use and drug-related problems. Two patient groups ≥65 years were selected based on general practitioner electronic medical records in nine practices; I. polypharmacy and II. ≥1 predefined general geriatric problems. Eligible patients were asked to complete the questionnaire and were interviewed afterwards. Agreement on information on medication use and drug-related problems collected with the questionnaire and interview was calculated. Ninety-seven patients participated. Of all medications used, 87.6 % (95 % CI 84.7-90.5) was reported identically in the questionnaire and interview. Agreement for the complete medication list was found for 45.4 % (95 % CI 35.8-55.3) of the patients. On drug-related problem level, agreement between questionnaire and interview was 75 %. Agreement tended to be lower in vulnerable patients characterized by ≥4 chronic diseases, ≥10 medications used and low health literacy. Information from a questionnaire showed reasonable agreement compared with interviewing. The patients reported more medications and drug-related problems in the interview than the questionnaire. Taking the limitations into account, a questionnaire seems a suitable tool for medication reviews that may replace an interview for most patients.

[Action-oriented versus state-oriented reactions to experimenter-induced failures].

Science.gov (United States)

Brunstein, J C

1989-01-01

The present study assessed different effects of action-oriented versus state-oriented styles of coping with failure on achievement-related performance and cognition. In a learned helplessness experiment, students were exposed to an academic failure situation and were then tested on a series of problem-solving tasks, either immediately after the pretreatment or after a delay of 24 hours. Performance and cognitive concomitants were measured during both experimental periods. Results demonstrated that action orientation was associated with self-immunizing cognitions during helplessness training. Action-oriented participants improved their performance level even after repeated failure feedbacks. Moreover, action-oriented students assigned to the delayed test condition responded with increased striving for success and showed performance increments, even in comparison with control subjects. In contrast, state-oriented participants developed symptoms of helplessness and showed impaired performance during failure inductions. In later tests on problem-solving tasks, state-oriented groups responded with increased fear of failure. Independent of immediate or delayed test conditions, they soon lapsed into new performance decrements.

[Analysis of drug-related problems in a tertiary university hospital in Barcelona (Spain)].

Science.gov (United States)

Ferrández, Olivia; Casañ, Borja; Grau, Santiago; Louro, Javier; Salas, Esther; Castells, Xavier; Sala, Maria

2018-05-07

To describe drug-related problems identified in hospitalized patients and to assess physicians' acceptance rate of pharmacists' recommendations. Retrospective observational study that included all drug-related problems detected in hospitalized patients during 2014-2015. Statistical analysis included a descriptive analysis of the data and a multivariate logistic regression to evaluate the association between pharmacists' recommendation acceptance rate and the variable of interest. During the study period 4587 drug-related problems were identified in 44,870 hospitalized patients. Main drug-related problems were prescription errors due to incorrect use of the computerized physician order entry (18.1%), inappropriate drug-drug combination (13.3%) and dose adjustment by renal and/or hepatic function (11.5%). Acceptance rate of pharmacist therapy advice in evaluable cases was 81.0%. Medical versus surgical admitting department, specific types of intervention (addition of a new drug, drug discontinuation and correction of a prescription error) and oral communication of the recommendation were associated with a higher acceptance rate. The results of this study allow areas to be identified on which to implement optimization strategies. These include training courses for physicians on the computerized physician order entry, on drugs that need dose adjustment with renal impairment, and on relevant drug interactions. Copyright © 2018 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Evaluation of brain scintigraphy and computerized tomography

International Nuclear Information System (INIS)

Cavailloles, F.; Dairou, R.; Desbleds, M.T.; Benoit, C.; Larmande, P.; Bok, B.; Alperovitch, A.

1983-01-01

In order to assess the clinical usefulness of brain computerized tomography and radionuclide scan, a prospective study was performed on a series of 554 patients. The detection rate was assessed as well as the identification rate of lesions. In addition, the usefulness of both tests was appreciated subjectively by two neurologists reviewing the patients' files. Both give reasonably similar results: computerized tomography is superior to radionuclide scan in the diagnosis of tumors and intracerebral hematomas, the radionuclide scan being slightly superior in the diagnosis of purely ischemic CVA and subdural hematomas. The superiority which was subjectively conceded to computerized tomography was greater than that objectively demonstrated. However, clinical usefulness of computerized tomography was judged important in only 50% of the cases. Moreover, to request both computerized tomography and radionuclide scan appeared as having no interest in 83% of the cases. In that series, the diagnostic hypotheses were in agreement with the final diagnosis in 88% of the cases. Bias encountered in this type of studies are discussed [fr

Computerized tomography in myotonic dystrophy

International Nuclear Information System (INIS)

Gellerich, I.; Mueller, D.; Koch, R.D.

1986-01-01

Besides clinical symptoms, progress and electromyography computerized tomography improves the diagnostics of myotonic dystrophy. Even small changes in muscular structure are detectable and especially the musculus soleus exhibits early and pronounced alterations. By means of density distribution pattern an improved characterization of the disease is possible. Additional information is obtained by cerebral computerized tomography. Atrophy of brain tissue is to be expected in all patients with myotonic dystrophy. (author)

Objective - oriented financial analysis introduction

Directory of Open Access Journals (Sweden)

Dessislava Kostova – Pickett

2018-02-01

Full Text Available The practice of financial analysis has been immeasurably strengthened in recent years thanks to the ongoing evolution of computerized approaches in the form of spreadsheets and computer-based financial models of different types. These devices not only relieved the analyst's computing task, but also opened up a wide range of analyzes and research into alternative sensitivity, which so far has not been possible. The main potential for object-oriented financial analysis consists in enormously expanding the analyst's capabilities through an online knowledge and information interface that has not yet been achieved through existing methods and software packages.

Computerized reactor monitor and control for research reactors

International Nuclear Information System (INIS)

Buerger, L.; Vegh, E.

1981-09-01

The computerized process control system developed in the Central Research Institute for Physics, Budapest, Hungary, is described together with its special applications at research reactors. The nuclear power of the Hungarian research reactor is controlled by this computerized system, too, while in Lybia many interesting reactor-hpysical calculations are built into the computerized monitor system. (author)

Renewed roles for librarians in problem-based learning in the medical curriculum.

Science.gov (United States)

Mi, Misa

2011-01-01

Problem-based learning (PBL) is a teaching-learning process or method of instruction that is widely used in medical education curricula. Librarians play important roles as facilitators for PBL as well as guides for information resources. Involvement in PBL activities presents unique opportunities to incorporate library resources and instruction into the medical curriculum. This article reviews the problem-based learning method within the conceptual framework of the learning theory of constructivism. It describes how a medical librarian at a U.S. medical school used emerging technologies to facilitate PBL small group case discussions, guide students to quality information resources, and enhance the learning environment for the PBL process.

Development of a computerized tomographic system based on the FAN-BEAM technique

International Nuclear Information System (INIS)

Junqueira, M.M.; Santos, C.A.C.; Borges, J.C.

1986-01-01

The Nuclear Instrumentation Laboratory, at COPPE/UFRJ, concentrates its researches in the development of computerized tomographic systems, looking for applications in industrial and medical non destructive analysing techniques. In this work we have projected and constructed a tomographic prototype, based on the FAN-BEAM technique for irradiating the object under analysis. An algorithm previously developed to analyse parallel beams, was modified and adapted to the FAN-BEAM geometry. (Author) [pt

Calling Orientations of Junior Doctors and Medical Interns in India: Cultural, Occupational and Relational Perspectives

Science.gov (United States)

Nath, Vandana

2017-01-01

This study examines the factors that shape calling orientations within the Indian context. Based on the narratives of 72 junior doctors and medical interns, it is found that participants identify with harbouring a calling both prior and subsequent to occupational entry. Although factors such as self-recognition of talent and sensemaking of work as…

Medication-related problem type and appearance rate in ambulatory hemodialysis patients

Directory of Open Access Journals (Sweden)

Drayer Debra K

2003-12-01

Full Text Available Abstract Background Hemodialysis (HD patients are at risk for medication-related problems (MRP. The MRP number, type, and appearance rate over time in ambulatory HD patients has not been investigated. Methods Randomly selected HD patients were enrolled to receive monthly pharmaceutical care visits. At each visit, MRP were identified through review of the patient chart, electronic medical record, patient interview, and communications with other healthcare disciplines. All MRP were categorized by type and medication class. MRP appearance rate was determined as the number of MRP identified per month/number of months in study. The number of MRP per patient-drug exposures were determined using: {[(number of patients × (mean number of medications]/(number of months of study} /number of MRP identified. Results were expressed as mean ± standard deviation or percentages. Results Patients were 62.6 ± 15.9 years old, had 6.4 ± 2.0 comorbid conditions, were taking 12.5 ± 4.2 medications, and 15.7 ± 7.2 doses per day at baseline. Medication-dosing problems (33.5%, adverse drug reactions (20.7%, and an indication that was not currently being treated (13.5% were the most common MRP. 5,373 medication orders were reviewed and a MRP was identified every 15.2 medication exposures. Overall MRP appearance rate was 0.68 ± 0.46 per patient per month. Conclusion MRP continue to occur at a high rate in ambulatory HD patients. Healthcare providers taking care of HD patients should be aware of this problem and efforts to avoid or resolve MRP should be undertaken at all HD clinics.

Educational Problems of Kermanshah Medical School: View Points of Students, Graduates and Faculty Members

Directory of Open Access Journals (Sweden)

soraia Siabani

2009-07-01

Full Text Available Background and purpose: In recent years although the number of students registering for medicines has decreased in Kermanshah University of Medical sciences parallel to other universities of medical sciences the quality of educational services has not improved the informal reports suggests that the competency of medical graduates is not satisfactory Since any intervention needs situation analysis this study was conducted to obtain viewpoints of three main groups of stockholders including faculty members, students and graduates on medical school problems and insufficiencies.Methods: In this qualitative study faculty members of medical schools, medical graduated of 2005-6, and medical students of different phases participated. With participation of these subjects Focus Group Discussion (FGD sessions were carried out. The goals of the projects were first explained for participants. In the end of each discussion session the discussions were careful transcribed. The sessions continued till the sessions get saturated. The transcript of discussion was thoroughly reviewed by researchers and codified. The problems were classified in 7 areas of management, planning, education goals, evaluation, ethics, teaching, and students.Results: The subjects believed that the most important problems in Kermanshah medical school include neglecting the student evaluation, no educational objectives or being inattentive to them, unwanted effects of pay for service plan, too much duties for interns (students, overload of medical duties and insufficiency in the number of faculty members, no rewarding system for teachers, inattention to needed outcomes, shortage of facilities for student in hospital and being negligent about mutual respect between students and teachers.Conclusion: some of the problems such as the effects of pay for service plan and insufficiency in the number of faculty members have solutions stemming beyond the university at Ministry of Health level

A survey of medical informatics in Belgium.

Science.gov (United States)

Roger, F H; Behets, M; Andre, J; de Moor, G; Sevens, C; Willems, J L

1987-01-01

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.

Medical Problem-Solving: A Critique of the Literature.

Science.gov (United States)

McGuire, Christine H.

1985-01-01

Prescriptive, decision-analysis of medical problem-solving has been based on decision theory that involves calculation and manipulation of complex probability and utility values to arrive at optimal decisions that will maximize patient benefits. The studies offer a methodology for improving clinical judgment. (Author/MLW)

[Hospital clinical engineer orientation and function in the maintenance system of hospital medical equipment].

Science.gov (United States)

Li, Bin; Zheng, Yunxin; He, Dehua; Jiang, Ruiyao; Chen, Ying; Jing, Wei

2012-03-01

The quantity of medical equipment in hospital rise quickly recent year. It provides the comprehensive support to the clinical service. The maintenance of medical equipment becomes more important than before. It is necessary to study on the orientation and function of clinical engineer in medical equipment maintenance system. Refer to three grade health care system, the community doctors which is called General practitioner, play an important role as the gatekeeper of health care system to triage and cost control. The paper suggests that hospital clinical engineer should play similar role as the gatekeeper of medical equipment maintenance system which composed by hospital clinical engineer, manufacture engineer and third party engineer. The hospital clinical engineer should be responsible of guard a pass of medical equipment maintenance quality and cost control. As the gatekeeper, hospital clinical engineer should take the responsibility of "General engineer" and pay more attention to safety and health of medical equipment. The responsibility description and future transition? development of clinical engineer as "General Engineer" is discussed. More attention should be recommended to the team building of hospital clinical engineer as "General Engineer".

Resource-oriented coaching for reduction of examination-related stress in medical students: an exploratory randomized controlled trial.

Science.gov (United States)

Kötter, Thomas; Niebuhr, Frank

2016-01-01

The years spent in acquiring medical education is considered a stressful period in the life of many students. Students whose mental health deteriorates during this long period of study are less likely to become empathic and productive physicians. In addition to other specific stressors, academic examinations seem to further induce medical school-related stress and anxiety. Combined group and individual resource-oriented coaching early in medical education might reduce examination-related stress and anxiety and, consequently, enhance academic performance. Good quality evidence, however, remains scarce. In this study, therefore, we explored the question of whether coaching affects examination-related stress and health in medical students. We conducted a randomized controlled trial. Students who registered for the first medical academic examination in August 2014 at the University of Lübeck were recruited and randomized into three groups. The intervention groups 1 and 2 received a 1-hour psychoeducative seminar. Group 1 additionally received two 1-hour sessions of individual coaching during examination preparation. Group 3 served as a control group. We compared changes in self-rated general health (measured by a single item), anxiety and depression (measured by the hospital anxiety and depression scale), as well as medical school stress (measured by the perceived medical school stress instrument). In order to further investigate the influence of group allocation on perceived medical school stress, we conducted a linear regression analysis. We saw a significant deterioration of general health and an increase in anxiety and depression scores in medical students while preparing for an examination. We found a small, but statistically significant, effect of group allocation on the development of perceived medical school stress. However, we could not differentiate between the effects of group coaching only and group coaching in combination with two sessions of individual

Medical-biological problems

International Nuclear Information System (INIS)

1986-01-01

The report contains data on operational and emergency staff of the Chernobyl nuclear power plant who were exposed to radiation as a consequence of the reactor accident, the size of the doses received and consequences for health. 203 persons were found to have acute radiation sickness. Of the 22 patients suffering from an extremely severe degree of acute radiation sickness, 19 died. Of the 23 patients with severe bone marrow syndrome, 7 died. For the majority of patients, clinical recovery occurred toward the end of the second month following the accident. The main harmful factor for all victims was the relatively uniform gamma- and beta-radiation effect in a dosage exceeding 1 Gy and, in the case of 35 people exceeding 4 Gy. Radiation damage to wide areas of the skin was one of the main factors contributing to the overall severe condition of the patients, and was a determining factor in the main fatal complications. A preliminary evaluation of the use of some biochemical and immunological tests in the event of accidental exposure to radiation and the methods of treatment and preliminary assessment of their effectiveness are presented. Another part of the report contains data on the doses from radiation exposure to the population of the town of Pripyat' until the time of evacuation and to the population in the 30 km zone around Chernobyl' nuclear power plant and radiation consequences of the accident for the population of different regions in the European part of the USSR, especially the problems related to the contamination of food products. The last part of the report gives some data on the organization of medical examinations of the population from the region around the Chernobyl' plant and on the long-term programmes for the medical and biological monitoring of the population and personnel

Computerized information system on the impacts of coal-fired energy development in the Southwest

International Nuclear Information System (INIS)

Layton, D.W.

1975-01-01

An important part of the process of assessing the environmental impacts of coal-fired energy development in the Southwest is the transfer of information between electric utilities, federal agencies, and the interested public. There are, however, several problems associated with the transfer of information among the different groups. The acquisition of factual material on power projects by the interested public, for example, is adversely affected by the sufficiency, convenience, and credibility of present sources. Efforts of electric utilities and federal agencies to effectively communicate impact information are hindered by the inability of existing sources to selectively transfer information and to rapidly transmit information on the cumulative impacts of many combinations of power plants. This research concerns the development and evaluation of a computerized information system designed to selectively transfer information on both the cumulative and individual impacts of several electric generating facilities located in the southwestern United States. The information system incorporates features of management information systems, environmental information systems, and an issue-oriented system developed at The University of Illinois, making it a hybrid system capable of communicating impact information derived from a variety of sources

Anti-3-[(18)F]FACBC positron emission tomography-computerized tomography and (111)In-capromab pendetide single photon emission computerized tomography-computerized tomography for recurrent prostate carcinoma: results of a prospective clinical trial.

Science.gov (United States)

Schuster, David M; Nieh, Peter T; Jani, Ashesh B; Amzat, Rianot; Bowman, F Dubois; Halkar, Raghuveer K; Master, Viraj A; Nye, Jonathon A; Odewole, Oluwaseun A; Osunkoya, Adeboye O; Savir-Baruch, Bital; Alaei-Taleghani, Pooneh; Goodman, Mark M

2014-05-01

We prospectively evaluated the amino acid analogue positron emission tomography radiotracer anti-3-[(18)F]FACBC compared to ProstaScint® ((111)In-capromab pendetide) single photon emission computerized tomography-computerized tomography to detect recurrent prostate carcinoma. A total of 93 patients met study inclusion criteria who underwent anti-3-[(18)F]FACBC positron emission tomography-computerized tomography plus (111)In-capromab pendetide single photon emission computerized tomography-computerized tomography for suspected recurrent prostate carcinoma within 90 days. Reference standards were applied by a multidisciplinary board. We calculated diagnostic performance for detecting disease. In the 91 of 93 patients with sufficient data for a consensus on the presence or absence of prostate/bed disease anti-3-[(18)F]FACBC had 90.2% sensitivity, 40.0% specificity, 73.6% accuracy, 75.3% positive predictive value and 66.7% negative predictive value compared to (111)In-capromab pendetide with 67.2%, 56.7%, 63.7%, 75.9% and 45.9%, respectively. In the 70 of 93 patients with a consensus on the presence or absence of extraprostatic disease anti-3-[(18)F]FACBC had 55.0% sensitivity, 96.7% specificity, 72.9% accuracy, 95.7% positive predictive value and 61.7% negative predictive value compared to (111)In-capromab pendetide with 10.0%, 86.7%, 42.9%, 50.0% and 41.9%, respectively. Of 77 index lesions used to prove positivity histological proof was obtained in 74 (96.1%). Anti-3-[(18)F]FACBC identified 14 more positive prostate bed recurrences (55 vs 41) and 18 more patients with extraprostatic involvement (22 vs 4). Anti-3-[(18)F]FACBC positron emission tomography-computerized tomography correctly up-staged 18 of 70 cases (25.7%) in which there was a consensus on the presence or absence of extraprostatic involvement. Better diagnostic performance was noted for anti-3-[(18)F]FACBC positron emission tomography-computerized tomography than for (111)In-capromab pendetide single

OR.NET RT: how service-oriented medical device architecture meets real-time communication.

Science.gov (United States)

Pfeiffer, Jonas H; Kasparick, Martin; Strathen, Benjamin; Dietz, Christian; Dingler, Max E; Lueth, Tim C; Timmermann, Dirk; Radermacher, Klaus; Golatowski, Frank

2018-02-23

Today's landscape of medical devices is dominated by stand-alone systems and proprietary interfaces lacking cross-vendor interoperability. This complicates or even impedes the innovation of novel, intelligent assistance systems relying on the collaboration of medical devices. Emerging approaches use the service-oriented architecture (SOA) paradigm based on Internet protocol (IP) to enable communication between medical devices. While this works well for scenarios with no or only soft timing constraints, the underlying best-effort communication scheme is insufficient for time critical data. Real-time (RT) networks are able to reliably guarantee fixed latency boundaries, for example, by using time division multiple access (TDMA) communication patterns. However, deterministic RT networks come with their own limitations such as tedious, inflexible configuration and a more restricted bandwidth allocation. In this contribution we overcome the drawbacks of both approaches by describing and implementing mechanisms that allow the two networks to interact. We introduce the first implementation of a medical device network that offers hard RT guarantees for control and sensor data and integrates into SOA networks. Based on two application examples we show how the flexibility of SOA networks and the reliability of RT networks can be combined to achieve an open network infrastructure for medical devices in the operating room (OR).

Nuclear Computerized Library for Assessing Reactor Reliability (NUCLARR): Volume 1, Summary description

International Nuclear Information System (INIS)

Gertman, D.I.; Gilmore, W.E.; Galyean, W.J.; Groh, M.R.; Gentillon, C.D.; Gilbert, B.G.

1988-02-01

A data management system has been implemented which supports a variety of risk-related analyses and provides a repository of hardware component failure and human error probability data to the risk analyst. The Nuclear Computerized Library for Assessing Reactor Reliability, NUCLARR, is an interactive, graphically oriented system which resides on a personal computer (PC) or PC-compatible environment. An overview of the data management system, including a description of data collection, specification, data structure, and taxonomies, is presented in Volume I of this report. Programming activities, procedures for processing data, user's guide, and hard copy data manual are presented in Volumes II through V

Computerised safeguards in Kazakhstan and its problems

International Nuclear Information System (INIS)

Yeligbayeva, G.Zh.

1999-01-01

Hereby will be described the Kazakhstan computerized safeguards system. Kazakhstan Atomic Energy Agency (KAEA) developed guides concerning of Y2K problem for facilities. The results of preliminary analyze of this problem are presented. (author)

Network oriented radiological and medical archive

Science.gov (United States)

Ferraris, M.; Frixione, P.; Squarcia, S.

2001-10-01

In this paper the basic ideas of NORMA (Network Oriented Radiological and Medical Archive) are discussed. NORMA is an original project built by a team of physicists in collaboration with radiologists in order to select the best Treatment Planning in radiotherapy. It allows physicians and health physicists, working in different places, to discuss on interesting clinical cases visualizing the same diagnostic images, at the same time, and highlighting zones of interest (tumors and organs at risk). NORMA has a client/server architecture in order to be platform independent. Applying World Wide Web technologies, it can be easily used by people with no specific computer knowledge providing a verbose help to guide the user through the right steps of execution. The client side is an applet while the server side is a Java application. In order to optimize execution the project also includes a proprietary protocol, lying over TCP/IP suite, that organizes data exchanges and control messages. Diagnostic images are retrieved from a relational database or from a standard DICOM (Digital Images and COmmunications in Medicine) PACS through the DICOM-WWW gateway allowing connection of the usual Web browsers, used by the NORMA system, to DICOM applications via the HTTP protocol. Browser requests are sent to the gateway from the Web server through CGI (Common Gateway Interface). DICOM software translates the requests in DICOM messages and organizes the communication with the remote DICOM Application.

The Problem-Oriented Project Work (PPL) Alternative in Self-Diected Higher Education

DEFF Research Database (Denmark)

Andersen, Anders Siig; Heilesen, Simon

2015-01-01

This chapter introduces an approach to higher education developed and practiced over four decades at Roskilde University in Denmark. Known as the Roskilde Model, the approach is characterized by (1) a special type of self-directed learning (SDL), named “problem-oriented project learning” (PPL); (2......) a way of organizing undergraduate education into broad interdisciplinary programs; and (3) an interdisciplinary profile where double-major graduate programs allow students to design their own academic and professional profiles. The chapter first explains similarities and differences between PPL and some...

Is the ICU staff satisfied with the computerized physician order entry? A cross-sectional survey study

Science.gov (United States)

Fumis, Renata Rego Lins; Costa, Eduardo Leite Vieira; Martins, Paulo Sergio; Pizzo, Vladimir; Souza, Ivens Augusto; Schettino, Guilherme de Paula Pinto

2014-01-01

Objective To evaluate the satisfaction of the intensive care unit staff with a computerized physician order entry and to compare the concept of the computerized physician order entry relevance among intensive care unit healthcare workers. Methods We performed a cross-sectional survey to assess the satisfaction of the intensive care unit staff with the computerized physician order entry in a 30-bed medical/surgical adult intensive care unit using a self-administered questionnaire. The questions used for grading satisfaction levels were answered according to a numerical scale that ranged from 1 point (low satisfaction) to 10 points (high satisfaction). Results The majority of the respondents (n=250) were female (66%) between the ages of 30 and 35 years of age (69%). The overall satisfaction with the computerized physician order entry scored 5.74±2.14 points. The satisfaction was lower among physicians (n=42) than among nurses, nurse technicians, respiratory therapists, clinical pharmacists and diet specialists (4.62±1.79 versus 5.97±2.14, pdigitalization decreased the workload and contributed to the intensive care unit quality with a user-friendly and accurate system and that digitalization provided concise information within a reasonable time frame. PMID:24770682

An orientation toward help-seeking for emotional problems.

NARCIS (Netherlands)

Tijhuis, M.A.R.; Peters, L.; Foets, M.

1990-01-01

In recent years, many researchers tried to explain the social selection in use of mental health care services. A modest role is attributed to the orientation toward help-seeking. This article studies this orientation. Our research-population consisted of 10,171 Dutch persons, aged 18 and older.

Resource-oriented coaching for reduction of examination-related stress in medical students: an exploratory randomized controlled trial

Directory of Open Access Journals (Sweden)

Kötter T

2016-08-01

Full Text Available Thomas Kötter,1 Frank Niebuhr2 1Institute of Social Medicine and Epidemiology, 2Institute of Family Medicine, University of Lübeck, Lübeck, Germany Introduction: The years spent in acquiring medical education is considered a stressful period in the life of many students. Students whose mental health deteriorates during this long period of study are less likely to become empathic and productive physicians. In addition to other specific stressors, academic examinations seem to further induce medical school-related stress and anxiety. Combined group and individual resource-oriented coaching early in medical education might reduce examination-related stress and anxiety and, consequently, enhance academic performance. Good quality evidence, however, remains scarce. In this study, therefore, we explored the question of whether coaching affects examination-related stress and health in medical students.Methods: We conducted a randomized controlled trial. Students who registered for the first medical academic examination in August 2014 at the University of Lübeck were recruited and randomized into three groups. The intervention groups 1 and 2 received a 1-hour psychoeducative seminar. Group 1 additionally received two 1-hour sessions of individual coaching during examination preparation. Group 3 served as a control group. We compared changes in self-rated general health (measured by a single item, anxiety and depression (measured by the hospital anxiety and depression scale, as well as medical school stress (measured by the perceived medical school stress instrument. In order to further investigate the influence of group allocation on perceived medical school stress, we conducted a linear regression analysis.Results: We saw a significant deterioration of general health and an increase in anxiety and depression scores in medical students while preparing for an examination. We found a small, but statistically significant, effect of group allocation on

COMPUTERIZED HEAT-TREATMENT IN A ZIMBABWEAN FACTORY

Directory of Open Access Journals (Sweden)

M. Collier

2012-01-01

Full Text Available In the context of Zimbabwe's current economic problems, parts of the manufacturing industry are turning their attention to the possibility of utilising local design talent in upgrading their manufacturing plants. This paper describes a project undertaken by the National University of Science and Technology to convert the heat-treatment process in a major manufacturing plant from semi -manual to a computerized one. The system comprises microcontroller connection to the furnaces and sensors, and communicates with a central computer on which software for a windowed user-interface is hosted. Experimental results for the system are presented, and a strategy for other companies in the same predicament is proposed.

The Implementation and Evaluation of a Project-Oriented Problem-Based Learning Module in a First Year Engineering Programme

Science.gov (United States)

McLoone, Seamus C.; Lawlor, Bob J.; Meehan, Andrew R.

2016-01-01

This paper describes how a circuits-based project-oriented problem-based learning educational model was integrated into the first year of a Bachelor of Engineering in Electronic Engineering programme at Maynooth University, Ireland. While many variations of problem based learning exist, the presented model is closely aligned with the model used in…

Students' Attitude toward and Acceptability of Computerized Adaptive Testing in Medical School and their Effect on the Examinees' Ability

Directory of Open Access Journals (Sweden)

Mee Young Kim

2005-06-01

Full Text Available An examinee's ability can be evaluated precisely using computerized adaptive testing (CAT, which is shorter than written tests and more efficient in terms of the duration of the examination. We used CAT for the second General Examination of 98 senior students in medical college on November 27, 2004. We prepared 1,050 pre-calibrated test items according to item response theory, which had been used for the General Examination administered to senior students in 2003. The computer was programmed to pose questions until the standard error of the ability estimate was smaller than 0.01. To determine the students' attitude toward and evaluation of CAT, we conducted surveys before and after the examination, via the Web. The mean of the students' ability estimates was 0.3513 and its standard deviation was 0.9097 (range -2.4680 to +2.5310. There was no significant difference in the ability estimates according to the responses of students to items concerning their experience with CAT, their ability to use a computer, or their anxiety before and after the examination (p>0.05. Many students were unhappy that they could not recheck their responses (49%, and some stated that there were too few examination items (24%. Of the students, 79 % had no complaints concerning using a computer and 63% wanted to expand the use of CAT. These results indicate that CAT can be implemented in medical schools without causing difficulties for users.

Effect of smartphone overuse on sleep problems in medical students

OpenAIRE

Pairoj Boonluksiri

2018-01-01

Background: Smartphones are used worldwide. Consequently, it does seem to be having an impact on health-related problems if overused. However, it is uncertain whether it is associated with sleep problems or poor learning. Objective: To determine the association between smartphone overuse and sleep problems in medical students as primary outcome and poor learning as secondary outcome. Methods: A cross-sectional study was conducted in 89 students having their own smartphones, at Hatyai...

Sexual orientation and medical history among Iranian people with Complete Androgen Insensitivity Syndrome and Congenital Adrenal Hyperplasia.

Science.gov (United States)

Khorashad, Behzad S; Roshan, Ghasem M; Reid, Alistair G; Aghili, Zahra; Hiradfar, Mehran; Afkhamizadeh, Mozhgan; Talaei, Ali; Aarabi, Azadeh; Ghaemi, Nosrat; Taghehchian, Negin; Saberi, Hedieh; Farahi, Nazanin; Abbaszadegan, Mohammad Reza

2017-01-01

To report sexual orientation, relationship status and medical history of Iranian people with Differences of Sex Development (DSD) who were raised female. Our participants consisted of nineteen 46,XY individuals with Complete Androgen Insensitivity Syndrome (CAIS) and eighteen 46,XX individuals with Congenital Adrenal Hyperplasia (CAH) who were raised as females and older than 13years. As well as their relationship status and detailed medical history, an expert psychiatrist assessed their sexual orientation by a semi-structured psychiatric interview with them and, where applicable, their parents. Five percent of CAH participants and 42% of CAIS participants were in a relationship, which was significantly different. All CAH individuals had been diagnosed at birth; 89% of CAIS had been diagnosed after puberty and due to primary amenorrhea and 11% were diagnosed in childhood due to inguinal hernia. Genital reconstructive surgery had been performed in 100% of CAH participants and 37% of CAIS. Regarding sexual contact experiences and sexual fantasies (androphilic, gynephilic or both), no significant differences were found. However, CAH females had significantly more gynephilic dreams (P=0.045). This study, notable as one of the rare from a non-western culture, described sexual, medical and socioeconomic status of 46,XX CAH and 46,XY CAIS individuals living in Iran. Although broadly in line with previous findings from Western cultures, Iranian CAH individuals had fewer romantic relationships, but in contrast to previous studies their sexual orientation was only different from CAIS in the contents of sexual dreams. Copyright © 2016 Elsevier Inc. All rights reserved.

Analysis of concrete material through gamma ray computerized tomography

International Nuclear Information System (INIS)

Oliveira Junior, J.M. de

2004-01-01

Computerized Tomography (CT) refers to the cross sectional imaging of an object from both transmission or reflection data collected by illuminating the object from many different directions. The most important contribution of CT is to greatly improve abilities to distinguish regions with different gamma ray transmittance and to separate over-lying structures. The mathematical problem of the CT imaging is that of estimating an image from its projections. These projections can represent, for example, the linear attenuation coefficient of γ-rays along the path of the ray. In this work we will present some new results obtained by using tomographic techniques to analyze column samples of concrete to check the distribution of various materials and structural problems. These concrete samples were made using different proportions of stone, sand and cement. Another set of samples with different proportions of sand and cement were also used to verify the outcome from the CT analysis and the differences between them. Those samples were prepared at the Material Laboratory of Faculdade de Engenharia de Sorocaba, following the same procedures used in real case of concrete tests. The projections used in this work was obtained by Mini Computerized Tomograph of Uniso (MTCU), located at the Experimental Nuclear Physics Laboratory at University of Sorocaba. This tomograph operates with a gamma ray source of 241 Am (photons of 60 keV and 100 mCi of intensity) and a NaI(Tl) solid state detector. The system features translation and rotation scanning modes, a 100 mm effective field of view, and 1 mm spatial resolution. The image reconstruction problem is solved using Discrete Filtered Backprojection (FBP). (author)

A Power Electronic and Drives Curriculum with Project-oriented and Problem-based Learning: A Dynamic Teaching Approach for the Future

DEFF Research Database (Denmark)

Blaabjerg, Frede

2002-01-01

extra study time. This paper present a teaching approach which makes it possible very fast for the student to get in-depth skills in this important area which is the problem-oriented and project-based learning. The trend and application of power electronics are illustrated. The necessary skills...... for power electronic engineers are outlined followed up by a discussion on how problem-oriented and project-based learning are implemented. A complete curriculum at Aalborg University is presented where different power electronics related projects at different study levels are carried out....

Study of sleep habits and sleep problems among medical students of pravara institute of medical sciences loni, Western maharashtra, India.

Science.gov (United States)

Giri, Pa; Baviskar, Mp; Phalke, Db

2013-01-01

Good quality sleep and adequate amount of sleep are important in order to have better cognitive performance and avoid health problems and psychiatric disorders. The aim of this study was to describe sleep habits and sleep problems in a population of undergraduates, interns and postgraduate students of Pravara Institute of Medical Sciences (Deemed University), Loni, Maharashtra, India. Sleep habits and problems were investigated using a convenience sample of students from Pravara Institute of Medical Sciences (Deemed University), Loni, Maharashtra, India. The study was carried out during Oct. to Dec. 2011 with population consisted of total 150 medical students. A self-administered questionnaire developed based on Epworth Daytime Sleepiness Scale and Pittsburgh Sleep Quality Index was used. Data was analyzed by using Statistical Package of Social Sciences (SPSS) version 16.0. In this study, out of 150 medical students, 26/150 (17.3%) students had abnormal levels of daytime sleepiness while 20/150 (13.3%) were border line. Sleep quality in females was better than the male. Disorders related to poor sleep qualities are significant problems among medical students in our institution. Caffeine and alcohol ingestion affected sleep and there was high level of daytime sleepiness. Sleep difficulties resulted in irritability and affected lifestyle and interpersonal relationships.

[Computerized ranking test in three French universities: Staff experience and students' feedback].

Science.gov (United States)

Roux, D; Meyer, G; Cymbalista, F; Bouaziz, J-D; Falgarone, G; Tesniere, A; Gervais, J; Cariou, A; Peffault de Latour, R; Marat, M; Moenaert, E; Guebli, T; Rodriguez, O; Lefort, A; Dreyfuss, D; Hajage, D; Ricard, J-D

2016-03-01

The year 2016 will be pivotal for the evaluation of French medical students with the introduction of the first computerized National Ranking Test (ECNi). The SIDES, online electronic system for medical student evaluation, was created for this purpose. All the universities have already organized faculty exams but few a joint computerized ranking test at several universities simultaneously. We report our experience on the organization of a mock ECNi by universities Paris Descartes, Paris Diderot and Paris 13. Docimological, administrative and technical working groups were created to organize this ECNi. Students in their fifth year of medical studies, who will be the first students to sit for the official ECNi in 2016, were invited to attend this mock exam that represented more than 50% of what will be proposed in 2016. A final electronic questionnaire allowed a docimological and organizational evaluation by students. An analysis of ratings and rankings and their distribution on a 1000-point scale were performed. Sixty-four percent of enrolled students (i.e., 654) attended the three half-day exams. No difference in total score and ranking between the three universities was observed. Students' feedback was extremely positive. Normalized over 1000 points, 99% of students were scored on 300 points only. Progressive clinical cases were the most discriminating test. The organization of a mock ECNi involving multiple universities was a docimological and technical success but required an important administrative, technical and teaching investment. Copyright © 2016 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

The Effectiveness of Problem-based Learning Approach on Students’ Skills in Technical Vocational Education and Training (TVET) Specifically on Programming Course Using a Computerized Numerical Control (CNC) Simulator

DEFF Research Database (Denmark)

Mohamad, Hasim Bin; de Graaff, Erik

2013-01-01

Industry has a great need for highly skilled technicians that graduate from Technical Vocational Education and Training (TVET). In a study started at Aalborg University (AAU) the purpose is to evaluate the effectiveness of the (PBL) approach on students’ skills, in particular on programming course...... using a Computerized Numerical Control (CNC) simulator. The study will use data from the German-Malaysian Institute in Malaysia. The findings of this study will provide a general guideline for educators in Technical and Vocational Education and Training (TVET) institutions in implementing Problem...

The evolution of computerized displays in accident management

International Nuclear Information System (INIS)

DeBor, J.

1988-01-01

Key regulations implemented by the NRC in 1982, which included requirements such as upgraded emergency operating procedures, detailed control room design reviews, the addition of a safety parameter display system, and the inclusion of a degreed shift technical advisor as part of the operating staff, have enabled the use of computerized displays to evolve as an integral part of accident management within each of the four main vendor groups. Problems, however, remain to be resolved in the area of technical content, information reliability, and rules for use in order to achieve the goal of more reliable accident management in nuclear power plants

Applying Particle Swarm Optimization for Solving Team Orienteering Problem with Time Windows

Directory of Open Access Journals (Sweden)

The Jin Ai

2014-01-01

Full Text Available The Team Orienteering Problem With Time Windows (TOPTW is a transportation problem case that have a set of vertices with a score, service time, and the time windows, start and final at a depot location. A number of paths are constructed to maximize the total collected score by the vertices which is visited. Each vertice can be visited only once and the visit can only start during the  time window of vertices. This paper proposes a Particle Swarm Optimization algorithm for solving the TOPTW, by defining a specific particle for representing the solution of TOPTW within the PSO algorithm and two alternatives, called PSO_TOPTW1 and PSO_TOPTW2, for translating the particle position to form the routes of the path. The performance of the proposed PSO algorithm is evaluated through some benchmark data problem available in the literature. The computational results show that the proposed PSO is able to produce sufficiently good TOPTW solutions that are comparable with corresponding solutions from other existing methods for solving the TOPTW.

Strong orientational coordinates and orientational order parameters for symmetric objects

International Nuclear Information System (INIS)

Haji-Akbari, Amir; Glotzer, Sharon C

2015-01-01

Recent advancements in the synthesis of anisotropic macromolecules and nanoparticles have spurred an immense interest in theoretical and computational studies of self-assembly. The cornerstone of such studies is the role of shape in self-assembly and in inducing complex order. The problem of identifying different types of order that can emerge in such systems can, however, be challenging. Here, we revisit the problem of quantifying orientational order in systems of building blocks with non-trivial rotational symmetries. We first propose a systematic way of constructing orientational coordinates for such symmetric building blocks. We call the arising tensorial coordinates strong orientational coordinates (SOCs) as they fully and exclusively specify the orientation of a symmetric object. We then use SOCs to describe and quantify local and global orientational order, and spatiotemporal orientational correlations in systems of symmetric building blocks. The SOCs and the orientational order parameters developed in this work are not only useful in performing and analyzing computer simulations of symmetric molecules or particles, but can also be utilized for the efficient storage of rotational information in long trajectories of evolving many-body systems. (paper)

Psychometrics behind Computerized Adaptive Testing.

Science.gov (United States)

Chang, Hua-Hua

2015-03-01

The paper provides a survey of 18 years' progress that my colleagues, students (both former and current) and I made in a prominent research area in Psychometrics-Computerized Adaptive Testing (CAT). We start with a historical review of the establishment of a large sample foundation for CAT. It is worth noting that the asymptotic results were derived under the framework of Martingale Theory, a very theoretical perspective of Probability Theory, which may seem unrelated to educational and psychological testing. In addition, we address a number of issues that emerged from large scale implementation and show that how theoretical works can be helpful to solve the problems. Finally, we propose that CAT technology can be very useful to support individualized instruction on a mass scale. We show that even paper and pencil based tests can be made adaptive to support classroom teaching.

Computerized Classification Testing with the Rasch Model

Science.gov (United States)

Eggen, Theo J. H. M.

2011-01-01

If classification in a limited number of categories is the purpose of testing, computerized adaptive tests (CATs) with algorithms based on sequential statistical testing perform better than estimation-based CATs (e.g., Eggen & Straetmans, 2000). In these computerized classification tests (CCTs), the Sequential Probability Ratio Test (SPRT) (Wald,…

Developing Programming Tools to Handle Traveling Salesman Problem by the Three Object-Oriented Languages

Directory of Open Access Journals (Sweden)

Hassan Ismkhan

2014-01-01

Full Text Available The traveling salesman problem (TSP is one of the most famous problems. Many applications and programming tools have been developed to handle TSP. However, it seems to be essential to provide easy programming tools according to state-of-the-art algorithms. Therefore, we have collected and programmed new easy tools by the three object-oriented languages. In this paper, we present ADT (abstract data type of developed tools at first; then we analyze their performance by experiments. We also design a hybrid genetic algorithm (HGA by developed tools. Experimental results show that the proposed HGA is comparable with the recent state-of-the-art applications.

Castem 2000: a modern approach of computerized structural analysis

International Nuclear Information System (INIS)

Verpeaux, P.; Millard, A.; Hoffmann, A.; Ebersolt, L.

1988-01-01

Since the early beginning of the computerized structural analysis, many general purpose programs have been developed. Their complexity has increased rapidly and they became difficult to use and to maintain. The needs for an improved user's friendliness and the treatment of complex coupled problems have led to a modern tool: CASTEM 2000. It has profited by the general progress in computers technology and by a twenty years experience in large finite element codes. Its basic principles as well as examples of applications will be presented in this paper

Classification of medication incidents associated with information technology.

Science.gov (United States)

Cheung, Ka-Chun; van der Veen, Willem; Bouvy, Marcel L; Wensing, Michel; van den Bemt, Patricia M L A; de Smet, Peter A G M

2014-02-01

Information technology (IT) plays a pivotal role in improving patient safety, but can also cause new problems for patient safety. This study analyzed the nature and consequences of a large sample of IT-related medication incidents, as reported by healthcare professionals in community pharmacies and hospitals. The medication incidents submitted to the Dutch central medication incidents registration (CMR) reporting system were analyzed from the perspective of the healthcare professional with the Magrabi classification. During classification new terms were added, if necessary. The principal source of the IT-related problem, nature of error. Additional measures: consequences of incidents, IT systems, phases of the medication process. From March 2010 to February 2011 the CMR received 4161 incidents: 1643 (39.5%) from community pharmacies and 2518 (60.5%) from hospitals. Eventually one of six incidents (16.1%, n=668) were related to IT; in community pharmacies more incidents (21.5%, n=351) were related to IT than in hospitals (12.6%, n=317). In community pharmacies 41.0% (n=150) of the incidents were about choosing the wrong medicine. Most of the erroneous exchanges were associated with confusion of medicine names and poor design of screens. In hospitals 55.3% (n=187) of incidents concerned human-machine interaction-related input during the use of computerized prescriber order entry. These use problems were also a major problem in pharmacy information systems outside the hospital. A large sample of incidents shows that many of the incidents are related to IT, both in community pharmacies and hospitals. The interaction between human and machine plays a pivotal role in IT incidents in both settings.

Structured Medication Review to Improve Pharmacotherapy in People with Intellectual Disability and Behavioural Problems.

Science.gov (United States)

Scheifes, Arlette; Egberts, Toine C G; Stolker, Joost Jan; Nijman, Henk L I; Heerdink, Eibert R

2016-07-01

Polypharmacy and chronic drug use are common in people with intellectual disability and behavioural problems, although evidence of effectiveness and safety in this population is lacking. This study examined the effects of a structured medication review and aimed to improve pharmacotherapy in inpatients with intellectual disability. In a treatment facility for people with mild to borderline intellectual disability and severe behavioural problems, a structured medication review was performed. Prevalence and type of drug-related problems (DRPs) and of the recommended and executed actions were calculated. In a total of 55 patients with intellectual disability and behavioural problems, 284 medications were prescribed, in which a DRP was seen in 106 (34%). No indication/unclear indication was the most prevalent DRP (70). Almost 60% of the recommended actions were also executed. This high prevalence of DRPs is worrying. The structured medication review is a valuable instrument to optimize pharmacotherapy and to support psychiatrists in adequate prescribing of both psychotropic and somatic drugs. © 2015 John Wiley & Sons Ltd.

An analytic approach to resolving problems in medical ethics.

Science.gov (United States)

Candee, D; Puka, B

1984-01-01

Education in ethics among practising professionals should provide a systematic procedure for resolving moral problems. A method for such decision-making is outlined using the two classical orientations in moral philosophy, teleology and deontology. Teleological views such as utilitarianism resolve moral dilemmas by calculating the excess of good over harm expected to be produced by each feasible alternative for action. The deontological view focuses on rights, duties, and principles of justice. Both methods are used to resolve the 1971 Johns Hopkins case of a baby born with Down's syndrome and duodenal atresia. PMID:6234395

An analytic approach to resolving problems in medical ethics.

Science.gov (United States)

Candee, D; Puka, B

1984-06-01

Education in ethics among practising professionals should provide a systematic procedure for resolving moral problems. A method for such decision-making is outlined using the two classical orientations in moral philosophy, teleology and deontology. Teleological views such as utilitarianism resolve moral dilemmas by calculating the excess of good over harm expected to be produced by each feasible alternative for action. The deontological view focuses on rights, duties, and principles of justice. Both methods are used to resolve the 1971 Johns Hopkins case of a baby born with Down's syndrome and duodenal atresia.

Comparison, with regard to safety, between a hard-wired reactor protection system and a computerized protection system. Pt. 1

International Nuclear Information System (INIS)

Buettner, W.E.

1976-07-01

The study compares a conventional hard-wired dynamic reactor protection system with a computerized protection system. In the comparison, only the unequivocally safety-oriented protection actions are considered. In the first part, the different structures of both systems and the method of verification for their functional safety will be described. In the second part, the mean unavailability in case of demand for both systems under defined conditions will be determined. (orig.) [de

[Current situations and problems of quality control for medical imaging display systems].

Science.gov (United States)

Shibutani, Takayuki; Setojima, Tsuyoshi; Ueda, Katsumi; Takada, Katsumi; Okuno, Teiichi; Onoguchi, Masahisa; Nakajima, Tadashi; Fujisawa, Ichiro

2015-04-01

Diagnostic imaging has been shifted rapidly from film to monitor diagnostic. Consequently, Japan medical imaging and radiological systems industries association (JIRA) have recommended methods of quality control (QC) for medical imaging display systems. However, in spite of its need by majority of people, executing rate is low. The purpose of this study was to validate the problem including check items about QC for medical imaging display systems. We performed acceptance test of medical imaging display monitors based on Japanese engineering standards of radiological apparatus (JESRA) X-0093*A-2005 to 2009, and performed constancy test based on JESRA X-0093*A-2010 from 2010 to 2012. Furthermore, we investigated the cause of trouble and repaired number. Medical imaging display monitors had 23 inappropriate monitors about visual estimation, and all these monitors were not criteria of JESRA about luminance uniformity. Max luminance was significantly lower year-by-year about measurement estimation, and the 29 monitors did not meet the criteria of JESRA about luminance deviation. Repaired number of medical imaging display monitors had 25, and the cause was failure liquid crystal panel. We suggested the problems about medical imaging display systems.

Stratification of mammographic computerized analysis by BI-RADS categories

International Nuclear Information System (INIS)

Lederman, Richard; Leichter, Isaac; Buchbinder, Shalom; Novak, Boris; Bamberger, Philippe; Fields, Scott

2003-01-01

The Breast Imaging Reporting and Data System (BI-RADS) was implemented to standardize characterization of mammographic findings. The purpose of the present study was to evaluate in which BI-RADS categories the changes recommended by computerized mammographic analysis are most beneficial. Archival cases including, 170 masses (101 malignant, 69 benign) and 63 clusters of microcalcifications (MCs; 36 malignant, 27 benign), were evaluated retrospectively, using the BI-RADS categories, by several radiologists, blinded to the pathology results. A computerized system then automatically extracted from the digitized mammogram features characterizing mammographic lesions, which were used to classify the lesions. The results of the computerized classification scheme were compared, by receiver operating characteristics (ROC) analysis, to the conventional interpretation. In the ''low probability of malignancy group'' (excluding BI-RADS categories 4 and 5), computerized analysis improved the A z of the ROC curve significantly, from 0.57 to 0.89. In the ''high probability of malignancy group'' (mostly category 5) the computerized analysis yielded an ROC curve with an A z of 0.99. In the ''intermediate probability of malignancy group'' computerized analysis improved the A z significantly, from 0.66 for to 0.83. Pair-wise analysis showed that in the latter group the modifications resulting from computerized analysis were correct in 83% of cases. Computerized analysis has the ability to improve the performance of the radiologists exactly in the BI-RADS categories with the greatest difficulties in arriving at a correct diagnosis. It increased the performance significantly in the problematic group of ''intermediate probability of malignancy'' and pinpointed all the cases with missed cancers in the ''low probability'' group. (orig.)

Computerized industrial tomography

International Nuclear Information System (INIS)

Ashraf, M.M.

1999-01-01

Computerized Tomographic (CT) has been used for a number of applications in the field of medicine and industry. For the last couple of years, the technique has been applied for the material characterization and detection of defects and flaws inside the industrial components of nuclear, aerospace and missile industries. A CT scanner of first generation was developed at the institute. The scanner has been used to demonstrate couple of applications of CT in the field of non destructive testing of materials. The data acquired by placing the test objects at various angles and scanning the object through a source detector assembly has been processed on a Pentium computer for image reconstruction using a filtered back projection method. The technique has been developed which can be modified and improved to study various other applications in materials science and a modern computerized tomographic facility can be established. (author)

Terminological problems in radiation diagnosis

International Nuclear Information System (INIS)

Rozenfel'd, L.G.

1991-01-01

It was noted the necessity of regulation of medical termonilogy. The introduction of terms radiation diagnosis, radiation therapy was justified, usage of terms xeroroentgenography, reconstructive tomography was recommended. In author's opinion it was expedient to exclude from utilization the terms diagnostic radiology, skiagraphy, electroroentgenography, computerized tomography

Medical education.

Science.gov (United States)

Krishnan, P

1992-01-01

In theory, the Medical Council of India (MCI) determines the standards and qualifications of medical schools. It also sanctions curricula and ensures standards. Yet no standards exist on the mode of selection in medical schools, duration of study, course content, student stipends or period of internship. It takes 4.5 years to finish medical school. Students undergo preclinical, paraclinical, and clinical training. Most courses are in English which tends to favor the urban elite. Students cannot always communicate with patients in local languages. Textbooks often provide medical examples unrelated to India. Pedagogy consists mainly of lectures and rote learning predominates. Curricula tend not to provide courses in community health. Students pick up on the elitist attitudes of the faculty. For example, faculty do not put much emphasis on community health, individual health, equity in health care delivery, and teamwork. Further the education system is not patient oriented, but hospital or disease oriented. Faculty should train students in creating sanitation programs, knowing local nutritious foods, and in making community diagnoses. Yet they tend to be practitioners 1st then educators. Further faculty are not paid well and are not always invited to take part in improving curriculum, so morale is often low. Moreover experience in health planning and management issues is not required for administrators. In addition, medical schools are not well equipped with learning aids, libraries, or teaching staff. Tax revenues finance medical education. 75% of graduating physicians set up a private practice. Further many physicians go to urban areas. 34-57% emigrate to other countries. The problems of medical education will not be solved until the political and economic system becomes more responsive to the health needs of the people.

[Problem areas and examples of best practice in intersectoral medication treatment--a literature review].

Science.gov (United States)

Mehrmann, Lena; Ollenschläger, Günter

2014-01-01

Transitions between the outpatient and inpatient sector are a critical phase in medication treatment. This article provides an overview of published problem areas and examples of best practice in the intersectoral medication treatment. Data with regard to related problem areas and examples of best practice was collected in August 2011 by a systematic literature research. The relevant literature was identified using the following databases and search engines: MEDLINE, The Cochrane Library, EMBASE, Google, and Google Scholar. Additionally, a hand search was done on the websites of SpringerLink and Thieme Connect. The initial search yielded a total of 4,409 records which were further selected in two screening steps and analysed according to their relevance. Of the remaining 63 records, 3 exclusively described problem areas, 11 of them examples of best practice, and 49 provided information on both problem areas and examples of best practice with regard to intersectoral medication treatment. Among other things, problem areas include varying legal regulations in inpatient and outpatient medication treatment, drug therapy interruptions after hospital discharge, or deficits in communication and continuity of care. Examples of best practice are projects, programmes, initiatives, recommendations, and points to consider with respect to medication reconciliation, pharmaceutical support, or transitions of care. Problem areas as well as examples of best practice are mainly focused on the transition from inpatient to outpatient care. Copyright © 2013. Published by Elsevier GmbH.

Undergraduate medical student's perceptions on traditional and problem based curricula: pilot study.

Science.gov (United States)

Meo, Sultan Ayoub

2014-07-01

To evaluate and compare students' perceptions about teaching and learning, knowledge and skills, outcomes of course materials and their satisfaction in traditional Lecture Based learning versus Problem-Based Learning curricula in two different medical schools. The comparative cross-sectional questionnaire-based study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia, from July 2009 to January 2011. Two different undergraduate medical schools were selected; one followed the traditional curriculum, while the other followed the problem-based learning curriculum. Two equal groups of first year medical students were selected. They were taught in respiratory physiology and lung function lab according to their curriculum for a period of two weeks. At the completion of the study period, a five-point Likert scale was used to assess students' perceptions on satisfaction, academic environment, teaching and learning, knowledge and skills and outcomes of course materials about effectiveness of problem-based learning compared to traditional methods. SPSS 19 was used for statistical analysis. Students used to problem-based learning curriculum obtained marginally higher scores in their perceptions (24.10 +/- 3.63) compared to ones following the traditional curriculum (22.67 +/- 3.74). However, the difference in perceptions did not achieve a level of statistical significance. Students following problem-based learning curriculum have more positive perceptions on teaching and learning, knowledge and skills, outcomes of their course materials and satisfaction compared to the students belonging to the traditional style of medical school. However, the difference between the two groups was not statistically significant.

Psychoanalysis and analytic psychotherapy in the NHS--a problem for medical ethics.

Science.gov (United States)

Wilkinson, G

1986-01-01

I question the place of psychoanalysis and psychoanalytically oriented psychotherapy in the National Health Service (NHS), with reference to published material; and, particularly, in relation to primary care, health economics and medical ethics. I argue that there are pressing clinical, research, economic, and ethical reasons in support of the contention that an urgent review of the extent and impact of psychoanalytic practices in the health service is called for. PMID:3735363

Medical and psychological problems faced by young Australian gap year travellers.

Science.gov (United States)

Furuya-Kanamori, Luis; Mills, Deborah; Sheridan, Sarah; Lau, Colleen

2017-09-01

Gap year travellers can potentially be exposed to many infectious diseases and other travel-related health problems including injuries and psychological problems. Currently, there is little information on health and wellbeing of this particular group of travellers. Participants were recruited from an organization that specialized in organising international gap year placements. Gap year travellers were asked to complete a pre-departure survey on demographics, placement destination and duration, previous travel experience, hobbies, risk taking behaviour, anticipated problems during the placement, and pre-travel preparations. After the placement, participants were asked to complete a post-trip survey on their experiences, problems, health issues, and medical treatment required. The 88 and 34 gap year travellers aged 17-23 years completed pre- and post-placement surveys respectively. The duration of placements ranged from 3 to 12 months. Psychological stressors were frequently reported [ n = 26 (76.5%) felt home sick; n = 18 (52.9%) experienced culture shock; n = 17 (50.0%) had difficulty communicating with the locals]. The majority of participants (91.2%) tried to work out a solution for the stressor on their own. Twenty-eight (82.4%) participants reported medical problems during their placement; the most common problems were sunburn ( n = 19; 55.9%), respiratory infections ( n = 15; 44.1%), weight change ( n = 14; 41.2%), and diarrhoea/food poisoning ( n = 13; 38.2%). Three participants (3.4%) were admitted to hospital; for a muscle injury, head injury and skin infection after getting a tribal tattoo. Psychological stressors were common, but most did not seek help. Some medical problems encountered during their placement may have been preventable with improved pre-departure preparation. Gap year, pre-departure, preparation. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e

Computerized tomography in orthopaedics and traumatology

International Nuclear Information System (INIS)

Boettger, E.; Heckl, R.; Rehabilitations-Krankenhaus Langensteinbach, Karlsbad

1981-01-01

Computerized tomography in traumatology is the selected method for the indications mentioned, so that angiographic investigations are only necessary in exceptional cases. Computerized tomography is also better than other methods when diagnozing soft part tumours, however, angiography is still indicated preoperatively for individual cases. CT is only good as additional help to conventional diagnostics with bone tumours. The differential diagnosis cysts-tumour is possible using contrast medium injections. The frequently large soft part share of tumours is recognizable with osteolytic tumours so that a better irradiation and operation planning can be effected. Diseases in the spinal canal can only be assessed with reservation using modern equipment. Lumbar dislocations of the disk can mostly not be sufficiently determined. Perivertebral abscesses can be certainly detected using computerized tomography. This is particularly so for abscesses prior to calcification. (orig.) [de

Problems associated with the organization and planning of medical aid for radiation accident casualties

International Nuclear Information System (INIS)

Jammet, H.P.

1977-01-01

Problems associated with the organization and planning of medical treatment for radiation accident casualties are considered for different types of radiation accident: whole-body or partial irradiation, external or internal contamination and small or large numbers of cases. The problems posed are ones of competence, urgency and capacity; on the diagnostic side there is the problem of evaluating the exposure or contamination and assessing the resultant damage, while on the treatment side the questions of first aid, conventional treatment and specialized treatment have to be considered. The solutions envisaged involve organization at the local and national levels and planning of medical treatment by skilled, multidisciplinary medical teams. (author)

Computerized information management for institutional review boards.

Science.gov (United States)

Hood, Maureen N; Gugerty, Brian; Levine, Richard; Ho, Vincent B

2005-01-01

The use of human subjects for medical research in most industrialized nations requires the scientific and ethical scrutiny of research proposals by a governing institutional review board (IRB) or its equivalent. As part of their primary charge to protect human subjects, IRBs are responsible for the regulatory oversight of not only the research protocol itself but also the research conduct of the investigators and, if applicable, the funding sponsor. This article will discuss the regulatory requirements for an accurate account of IRB protocols and investigators and present an overview of the general flow of information for an IRB protocol. The current and potential uses of information management systems by IRBs will also be reviewed and accompanied by a discussion of the potential advantages and disadvantages of various computerized information systems for management of clinical research.

Combined study of 99mTc-HMPAO SPECT and computerized electroencephalographic topography (CET) in patients with medically refractory complex partial epilepsy

International Nuclear Information System (INIS)

Rodrigues, M.; Botelho, M.M.; Fonseca, A.T.; Peter, J.P.; Pimentel, T.; Vieira, M.R.

1996-01-01

For successful surgery for drug-resistant partial epilepsy the site of the seizure focus needs to be known exactly. The purpose of this study was to compare the evaluation of the regional cerebral blood flow (rCBF) (localization and degree of disturbances) by 99m Tc-hexamethylpropylene-amineoxime (HMPAO) single photon emission computed tomography (SPECT) with computerized electroencephalographic topography (CET) and transmission computed X-ray tomography (CT) in partial epilepsy. The study included 20 patients with medically refractory complex partial seizures. Of the 20 patients included, 15 were studied interictally, four ictally and one in both states, interictally and ictally. 99m Tc-HMPAO SPECT detected rCBF changes in 95% of the patients. Interictal studies demonstrated focal areas of hypoperfusion in 93% of the patients. Ictal studies demonstrated an area of hyperperfusion in all patients. Blood flow disturbances in deeper structures of the brain, such as basal ganglia, could be detected. The areas with abnormal 99m Tc-HMPAO uptake were concordant, in localization, with CET in 85% of the patients. Abnormal data with CT scans were found in only 45% of the patients. Focal lesions were found in 20% of the patients by CT scans. 99m Tc-HMPAO SPECT combined with CET may be a useful screening procedure prior to referral for invasive diagnostic procedures in future management of patients with medically refractory complex partial seizures. (author)

A comparative study of six European databases of medically oriented Web resources.

Science.gov (United States)

Abad García, Francisca; González Teruel, Aurora; Bayo Calduch, Patricia; de Ramón Frias, Rosa; Castillo Blasco, Lourdes

2005-10-01

The paper describes six European medically oriented databases of Web resources, pertaining to five quality-controlled subject gateways, and compares their performance. The characteristics, coverage, procedure for selecting Web resources, record structure, searching possibilities, and existence of user assistance were described for each database. Performance indicators for each database were obtained by means of searches carried out using the key words, "myocardial infarction." Most of the databases originated in the 1990s in an academic or library context and include all types of Web resources of an international nature. Five databases use Medical Subject Headings. The number of fields per record varies between three and nineteen. The language of the search interfaces is mostly English, and some of them allow searches in other languages. In some databases, the search can be extended to Pubmed. Organizing Medical Networked Information, Catalogue et Index des Sites Médicaux Francophones, and Diseases, Disorders and Related Topics produced the best results. The usefulness of these databases as quick reference resources is clear. In addition, their lack of content overlap means that, for the user, they complement each other. Their continued survival faces three challenges: the instability of the Internet, maintenance costs, and lack of use in spite of their potential usefulness.

Child Psychotherapy, Child Analysis, and Medication: A Flexible, Integrative Approach.

Science.gov (United States)

Whitman, Laura

2015-01-01

For children with moderate to severe emotional or behavioral problems, the current approach in child psychiatry is to make an assessment for the use of both psychotherapy and medication. This paper describes integration of antidepressants and stimulants with psychoanalytically oriented techniques.

Development of a clinician reputation metric to identify appropriate problem-medication pairs in a crowdsourced knowledge base.

Science.gov (United States)

McCoy, Allison B; Wright, Adam; Rogith, Deevakar; Fathiamini, Safa; Ottenbacher, Allison J; Sittig, Dean F

2014-04-01

Correlation of data within electronic health records is necessary for implementation of various clinical decision support functions, including patient summarization. A key type of correlation is linking medications to clinical problems; while some databases of problem-medication links are available, they are not robust and depend on problems and medications being encoded in particular terminologies. Crowdsourcing represents one approach to generating robust knowledge bases across a variety of terminologies, but more sophisticated approaches are necessary to improve accuracy and reduce manual data review requirements. We sought to develop and evaluate a clinician reputation metric to facilitate the identification of appropriate problem-medication pairs through crowdsourcing without requiring extensive manual review. We retrieved medications from our clinical data warehouse that had been prescribed and manually linked to one or more problems by clinicians during e-prescribing between June 1, 2010 and May 31, 2011. We identified measures likely to be associated with the percentage of accurate problem-medication links made by clinicians. Using logistic regression, we created a metric for identifying clinicians who had made greater than or equal to 95% appropriate links. We evaluated the accuracy of the approach by comparing links made by those physicians identified as having appropriate links to a previously manually validated subset of problem-medication pairs. Of 867 clinicians who asserted a total of 237,748 problem-medication links during the study period, 125 had a reputation metric that predicted the percentage of appropriate links greater than or equal to 95%. These clinicians asserted a total of 2464 linked problem-medication pairs (983 distinct pairs). Compared to a previously validated set of problem-medication pairs, the reputation metric achieved a specificity of 99.5% and marginally improved the sensitivity of previously described knowledge bases. A

Self-Handicapping Prior to Academic-Oriented Tasks in Children with Attention Deficit/Hyperactivity Disorder (ADHD): Medication Effects and Comparisons with Controls

Science.gov (United States)

Waschbusch, Daniel A.; Craig, Rebecca; Pelham, William E., Jr.; King, Sara

2007-01-01

The authors examined self-handicapping prior to academic-oriented tasks in children with and without ADHD and examined whether stimulant medication influenced self-handicapping. Participants were 61 children ages 6 to 13, including 22 children with ADHD tested after taking a placebo, 21 children with ADHD tested after taking stimulant medication,…

Stratification of mammographic computerized analysis by BI-RADS categories

Energy Technology Data Exchange (ETDEWEB)

Lederman, Richard [Department of Radiology, Hadassah University Hospital, Ein Kerem, Jerusalem (Israel); Leichter, Isaac [Department of Electro-Optics, Jerusalem College of Technology, P.O.B. 16031, Jerusalem (Israel); Buchbinder, Shalom [Department of Radiology of The Montefiore Medical Center, The University Hospital for the Albert Einstein College of Medicine, Bronx, New York (United States); Novak, Boris [Department of Applied Mathematics, Jerusalem College of Technology, P.O.B. 16031, Jerusalem 91160 (Israel); Bamberger, Philippe [Department of Electronics, Jerusalem College of Technology, POB 16031, Jerusalem (Israel); Fields, Scott [Department of Radiology, Hadassah University Hospital, Mt. Scopus, Jerusalem (Israel)

2003-02-01

The Breast Imaging Reporting and Data System (BI-RADS) was implemented to standardize characterization of mammographic findings. The purpose of the present study was to evaluate in which BI-RADS categories the changes recommended by computerized mammographic analysis are most beneficial. Archival cases including, 170 masses (101 malignant, 69 benign) and 63 clusters of microcalcifications (MCs; 36 malignant, 27 benign), were evaluated retrospectively, using the BI-RADS categories, by several radiologists, blinded to the pathology results. A computerized system then automatically extracted from the digitized mammogram features characterizing mammographic lesions, which were used to classify the lesions. The results of the computerized classification scheme were compared, by receiver operating characteristics (ROC) analysis, to the conventional interpretation. In the ''low probability of malignancy group'' (excluding BI-RADS categories 4 and 5), computerized analysis improved the A{sub z}of the ROC curve significantly, from 0.57 to 0.89. In the ''high probability of malignancy group'' (mostly category 5) the computerized analysis yielded an ROC curve with an A {sub z}of 0.99. In the ''intermediate probability of malignancy group'' computerized analysis improved the A {sub z}significantly, from 0.66 for to 0.83. Pair-wise analysis showed that in the latter group the modifications resulting from computerized analysis were correct in 83% of cases. Computerized analysis has the ability to improve the performance of the radiologists exactly in the BI-RADS categories with the greatest difficulties in arriving at a correct diagnosis. It increased the performance significantly in the problematic group of ''intermediate probability of malignancy'' and pinpointed all the cases with missed cancers in the ''low probability'' group. (orig.)

Development of the PEBLebl Traveling Salesman Problem Computerized Testbed

Science.gov (United States)

Mueller, Shane T.; Perelman, Brandon S.; Tan, Yin Yin; Thanasuan, Kejkaew

2015-01-01

The traveling salesman problem (TSP) is a combinatorial optimization problem that requires finding the shortest path through a set of points ("cities") that returns to the starting point. Because humans provide heuristic near-optimal solutions to Euclidean versions of the problem, it has sometimes been used to investigate human visual…

Application of EGS and ETRAN to Problems in Medical Physics and Dosimetry

CERN Document Server

Nelson, W R

1980-01-01

The author looks at a few applications of Monte Carlo programs to problems of interest in medical physics and dosimetry. In particular, two areas are considered: 1) bremsstrahlung production from medical accelerators; 2) photon dosimetry at medium to low energies. (16 refs) .

Validation of a Crowdsourcing Methodology for Developing a Knowledge Base of Related Problem-Medication Pairs.

Science.gov (United States)

McCoy, A B; Wright, A; Krousel-Wood, M; Thomas, E J; McCoy, J A; Sittig, D F

2015-01-01

Clinical knowledge bases of problem-medication pairs are necessary for many informatics solutions that improve patient safety, such as clinical summarization. However, developing these knowledge bases can be challenging. We sought to validate a previously developed crowdsourcing approach for generating a knowledge base of problem-medication pairs in a large, non-university health care system with a widely used, commercially available electronic health record. We first retrieved medications and problems entered in the electronic health record by clinicians during routine care during a six month study period. Following the previously published approach, we calculated the link frequency and link ratio for each pair then identified a threshold cutoff for estimated problem-medication pair appropriateness through clinician review; problem-medication pairs meeting the threshold were included in the resulting knowledge base. We selected 50 medications and their gold standard indications to compare the resulting knowledge base to the pilot knowledge base developed previously and determine its recall and precision. The resulting knowledge base contained 26,912 pairs, had a recall of 62.3% and a precision of 87.5%, and outperformed the pilot knowledge base containing 11,167 pairs from the previous study, which had a recall of 46.9% and a precision of 83.3%. We validated the crowdsourcing approach for generating a knowledge base of problem-medication pairs in a large non-university health care system with a widely used, commercially available electronic health record, indicating that the approach may be generalizable across healthcare settings and clinical systems. Further research is necessary to better evaluate the knowledge, to compare crowdsourcing with other approaches, and to evaluate if incorporating the knowledge into electronic health records improves patient outcomes.

Diagnostic perspectives of mobile x-ray computerized tomography

International Nuclear Information System (INIS)

Portnoj, L.M.; Dibirov, M.P.; Denisova, L.B.

1992-01-01

Mobile x-ray computerized tomography (CT) and an organization and methodological scheme of its application were assessed. CT is realized in special hospitals of large regions, where the patients with the optimal indications for CT are assembled. Over 15000 examinations were carried out with the use of the suggested CT program over 4 years, that resulted in detection of 1295 brain tumors, 804 cases with neoplastic involvement of the abdominal cavity and the retroperitoneal space. Wide application of mobile CT devices according to the program will help to decide the problem of unavailability of such examinations. One mobile device may replace 3 permanent CT devices

Medical databases in studies of drug teratogenicity: methodological issues

Directory of Open Access Journals (Sweden)

Vera Ehrenstein

2010-03-01

Full Text Available Vera Ehrenstein1, Henrik T Sørensen1, Leiv S Bakketeig1,2, Lars Pedersen11Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 2Norwegian Institute of Public Health, Oslo, NorwayAbstract: More than half of all pregnant women take prescription medications, raising concerns about fetal safety. Medical databases routinely collecting data from large populations are potentially valuable resources for cohort studies addressing teratogenicity of drugs. These include electronic medical records, administrative databases, population health registries, and teratogenicity information services. Medical databases allow estimation of prevalences of birth defects with enhanced precision, but systematic error remains a potentially serious problem. In this review, we first provide a brief description of types of North American and European medical databases suitable for studying teratogenicity of drugs and then discuss manifestation of systematic errors in teratogenicity studies based on such databases. Selection bias stems primarily from the inability to ascertain all reproductive outcomes. Information bias (misclassification may be caused by paucity of recorded clinical details or incomplete documentation of medication use. Confounding, particularly confounding by indication, can rarely be ruled out. Bias that either masks teratogenicity or creates false appearance thereof, may have adverse consequences for the health of the child and the mother. Biases should be quantified and their potential impact on the study results should be assessed. Both theory and software are available for such estimation. Provided that methodological problems are understood and effectively handled, computerized medical databases are a valuable source of data for studies of teratogenicity of drugs.Keywords: databases, birth defects, epidemiologic methods, pharmacoepidemiology

Organizational changes and automation: Towards a customer-oriented automation: Part 3

International Nuclear Information System (INIS)

Van Gelder, J.W.

1994-01-01

Automation offers great opportunities in the efforts of energy utilities in the Netherlands to reorganize towards more customer-oriented businesses. However, automation in itself is not enough. First, the organizational structure has to be changed considerably. Various energy utilities have already started on it. The restructuring principle is the same everywhere, but the way it is implemented differs widely. In this article attention is paid to the necessity of realizing an integrated computerized system, which, however, is not feasible at the moment. The second best alternative is to use various computerized systems, capable of two-way data exchange. Two viable approaches are discussed: (1) one operating system on which all automated systems within a company should run, or (2) a selective system linking on the basis of required speed information exchange. Option (2) offers more freedom of selecting the system. 2 figs

Measuring the performance of attention networks with the Dalhousie Computerized Attention Battery (DalCAB: Methodology and reliability in healthy adults

Directory of Open Access Journals (Sweden)

Stephanie Anne Holland Jones

2016-06-01

Full Text Available Attention is an important, multifaceted cognitive domain that has been linked to three distinct, yet interacting, networks: alerting, orienting, and executive control. The measurement of attention and deficits of attention within these networks is critical to the assessment of many neurological and psychiatric conditions in both research and clinical settings. The Dalhousie Computerized Attention Battery (DalCAB was created to assess attentional functions related to the three attention networks using a range of tasks including: simple reaction time, go/no-go, choice reaction time, dual task, flanker, item and location working memory and visual search. The current study provides preliminary normative data, test-retest reliability (intraclass correlations and practice effects in DalCAB performance 24-hours after baseline for healthy young adults (n = 96, 18-31 years. Performance on the DalCAB tasks demonstrated Good to Excellent test-retest reliability for mean reaction time, while accuracy and difference measures (e.g., switch costs, interference effects and working memory load effects were most reliable for tasks that require more extensive cognitive processing (e.g., choice reaction time, flanker, dual task, and conjunction search. Practice effects were common and pronounced at the 24-hour interval. In addition, performance related to specific within-task parameters of the DalCAB sub-tests provides preliminary support for future formal assessment of the convergent validity of our interpretation of the DalCAB as a potential clinical and research assessment tool for measuring aspects of attention related to the alerting, orienting and executive control networks.Keywords: computerized assessment; attention; orienting; alerting; executive function

Agreement between questionnaire and medical records on some health and socioeconomic problems among poisoning cases

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Fathelrahman Ahmed I

2009-09-01

Full Text Available Abstract Background The main objective of the present study was to evaluate the agreement between questionnaire and medical records on some health and socioeconomic problems among poisoning cases. Methods Cross-sectional sample of 100 poisoning cases consecutively admitted to the Hospital Pulau Pinang, Malaysia during the period from September 2003 to February 2004 were studied. Data on health and socioeconomic problems were collected both by self-administered questionnaire and from medical records. Agreement between the two sets of data was assessed by calculating the concordance rate, Kappa (k and PABAK. McNemar statistic was used to test differences between categories. Results Data collected by questionnaire and medical records showed excellent agreement on the "marital status"; good agreements on "chronic illness", "psychiatric illness", and "previous history of poisoning"; and fair agreements on "at least one health problem", and "boy-girl friends problem". PABAK values suggest better agreements' measures. Conclusion There were excellent to good agreements between questionnaire and medical records on the marital status and most of the health problems and fair to poor agreements on the majority of socioeconomic problems. The implications of those findings were discussed.

Computerized techniques pave the way for drug-drug interaction prediction and interpretation

Directory of Open Access Journals (Sweden)

Reza Safdari

2016-06-01

Results: Computerized data-mining in pharmaceutical sciences and related databases provide new key transformative paradigms that can revolutionize the treatment of diseases and hence medical care. Given that various aspects of drug discovery and pharmacotherapy are closely related to the clinical and molecular/biological information, the scientifically sound databases (e.g., DDIs, ADRs can be of importance for the success of pharmacotherapy modalities. Conclusion: A better understanding of DDIs not only provides a robust means for designing more effective medicines but also grantees patient safety.

Curricular trends in Malaysian medical schools: innovations within.

Science.gov (United States)

Azila, Nor Mohd Adnan; Rogayah, Jaafar; Zabidi-Hussin, Zabidi Azhar Mohd Hussin

2006-09-01

Various curricular innovations were adopted by medical schools worldwide in an attempt to produce medical graduates that could meet future healthcare needs of society locally and globally. This paper presents findings on curricular approaches implemented in Malaysian medical schools, in trying to meet those needs. Information was obtained from published records, responses from various questionnaires, personal communication and involvement with curricular development. Curricular innovations tended to be implemented in new medical schools upon their establishment. Established medical schools seemed to implement these innovations much later. Curricular trends appear to move towards integration, student-centred and problem-based learning as well as community-oriented medical education, with the Student-centred learning, Problem-based learning, Integrated teaching, Community-based education, Electives and Systematic programme (SPICES) model used as a reference. The focus is based on the premise that although the short-term aim of undergraduate medical education in Malaysia is to prepare graduates for the pre-registration house officer year, they must be able to practise and make decisions independently and be sensitive to the needs of the country's multiracial, multi-religious, and often remote communities. In most cases, curricular planning starts with a prescriptive model where planners focus on several intended outcomes. However, as the plan is implemented and evaluated it becomes descriptive as the planners reassess the internal and external factors that affect outcomes. A common trend in community-oriented educational activities is evident, with the introduction of interesting variations, to ensure that the curriculum can be implemented, sustained and the intended outcomes achieved.

Research on accounting transition from computerization to informationization

Directory of Open Access Journals (Sweden)

Shu Chen

2017-11-01

Full Text Available The application for computer technology, digitalization technology and network technology in the accounting field has promoted the development of accounting informationization. Accounting informationization is a product integrated with traditional accounting theory and modern information technology, which is an inevitable trend of continuous development of modern accounting. This paper discusses the basic concepts and characteristics of accounting computerization and informationization based on the normative research method and literature data method, analyzes the feasibility of accounting transition from computerization to informationization, and finally puts forward the specific approaches and ultimate goals of accounting transition from computerization to informationization.

Impact of supply problems of preservative-free glaucoma medications on patients and hospital staff.

Science.gov (United States)

Shah, Shima; Theodossiades, Julia; Chapman, Kristin; Murdoch, Ian

2015-03-01

Glaucoma is a chronic ocular disease, which is usually managed with long-term daily medical therapy, in the form of eye drops. Patients who are intolerant to preservatives in topical medicines require preservative-free versions. From early 2011 patients attending Moorfields Eye Hospital, London, UK, started to report recurring problems with the supply of the following preservative-free glaucoma medications: Timolol 0.25% (Timoptol 0.25%, MSD UK); Dorzolamide (Trusopt, MSD UK); Dorzolamide and Timolol 0.5% (Cosopt, MSD UK). This study investigates the impact of the supply problems of these medications at Moorfields Eye Hospital from a patient, administrative and clinical perspective. Information was sought by interviewing both patients and hospital staff, and by a retrospective case note review between April 2010 and May 2013. Many hospital roles, both administrative and clinical, were involved in attempting to resolve the impact of the supply problems. All staff reported a considerable increase in their workload. At the peak of the problem, the glaucoma secretaries received about 150 enquiries per week. A review of 83 sets of patient notes, retrieved from a random sample of 125 patients, showed that 22% encountered a supply problem. Of these, more than one-third attended Moorfields Eye Hospital Accident & Emergency (A&E) for repeat supplies and 89% eventually had their medication changed. In telephone interviews with 39 of a random sample of 50 patients (a subset of the 83 notes retrieved), 59% of the interviewees reported a supply problem. Of these, one-third attended Moorfields Eye Hospital A&E for repeat supplies and half eventually required an alternative medication. Some patients reported going to considerable lengths to obtain ongoing supplies in the community. This study shows that medication supply problems can have a major impact on patients and hospital services. Supply problems occur across many fields of medicine and with increasing frequency. The

Computerizing clinical practice guidelines

DEFF Research Database (Denmark)

Lyng, Karen Marie

It is well described that hospitals have problems with sustaining high quality of care and expedient introduction of new medical knowledge. Clinical practice guidelines (CPGs) have been promoted as a remedy to deal with these problems. It is, however, also well described that application and comp......It is well described that hospitals have problems with sustaining high quality of care and expedient introduction of new medical knowledge. Clinical practice guidelines (CPGs) have been promoted as a remedy to deal with these problems. It is, however, also well described that application...... is comprised by fieldwork in three oncology departments and a case study of advanced life support. Although close to all patients within oncology are treated according to a CPG, I found limited application of physical CPGs and web-based CPG portals. However, I found comprehensive application of activity...... of the business strategic aims, and 3) analysis and formalization of CPGs. This will imply orchestration of design teams with competencies from a wide array of disciplines such as health practice, business management, knowledge management and information systems....

Cranial computerized tomography in children suffering from acute leukemia

International Nuclear Information System (INIS)

Metz, O.

1981-01-01

Cranial computerized (axial) tomography permits a more complete neurologic supervision of children with acute leukemia and a better knowledge of the frequency and varieties of cerebral complications in leukemia. Endocranial complications in acute leukemia are essentially infiltrative, hemorrhagic, infectious or iatrogenic. Cranial computerized tomography can demonstrate cerebral changes in meningeal leukemia, hemorrhages, calcifications, brain atrophy or leukencephalopathy. The preliminary results of cranial computerized tomography in childhood leukemia suggest that the iatrogenic main lesion of the brain due to combined radiation-chemotherapy is atrophy whereas that of the intrathecal cytostatic therapy is demyelination. Accurate diagnostics and control of possible cerebral complications in therapy of leukemia is essentially for appropriate therapeutic management. For that cranial computerized tomography is the best method to a effective supervision of the brain. (author)

New fuzzy support vector machine for the class imbalance problem in medical datasets classification.

Science.gov (United States)

Gu, Xiaoqing; Ni, Tongguang; Wang, Hongyuan

2014-01-01

In medical datasets classification, support vector machine (SVM) is considered to be one of the most successful methods. However, most of the real-world medical datasets usually contain some outliers/noise and data often have class imbalance problems. In this paper, a fuzzy support machine (FSVM) for the class imbalance problem (called FSVM-CIP) is presented, which can be seen as a modified class of FSVM by extending manifold regularization and assigning two misclassification costs for two classes. The proposed FSVM-CIP can be used to handle the class imbalance problem in the presence of outliers/noise, and enhance the locality maximum margin. Five real-world medical datasets, breast, heart, hepatitis, BUPA liver, and pima diabetes, from the UCI medical database are employed to illustrate the method presented in this paper. Experimental results on these datasets show the outperformed or comparable effectiveness of FSVM-CIP.

New Fuzzy Support Vector Machine for the Class Imbalance Problem in Medical Datasets Classification

Directory of Open Access Journals (Sweden)

Xiaoqing Gu

2014-01-01

Full Text Available In medical datasets classification, support vector machine (SVM is considered to be one of the most successful methods. However, most of the real-world medical datasets usually contain some outliers/noise and data often have class imbalance problems. In this paper, a fuzzy support machine (FSVM for the class imbalance problem (called FSVM-CIP is presented, which can be seen as a modified class of FSVM by extending manifold regularization and assigning two misclassification costs for two classes. The proposed FSVM-CIP can be used to handle the class imbalance problem in the presence of outliers/noise, and enhance the locality maximum margin. Five real-world medical datasets, breast, heart, hepatitis, BUPA liver, and pima diabetes, from the UCI medical database are employed to illustrate the method presented in this paper. Experimental results on these datasets show the outperformed or comparable effectiveness of FSVM-CIP.

Study of Sleep Habits and Sleep Problems Among Medical Students ...

African Journals Online (AJOL)

characteristics, psychiatric illness, and some types of physical illness. ... to poor sleep qualities are significant problems among medical students in our institution. Caffeine and .... prepare for post graduation and also get to play a role (albeit a.

Mediators for internalizing problems in adolescents of parents with chronic medical condition

NARCIS (Netherlands)

Sieh, D.S.; Oort, F.J.; Visser-Meily, J.M.A.; Meijer, A.M.

2014-01-01

Parents’ chronic medical condition (CMC) is related to internalizing problem behavior in adolescents. Following the transactional stress and coping (TSC) model of Hocking and Lochman, our study examines whether the effect of illness and demographic parameters on the child’s internalizing problems is

Medical physics 2013. Abstracts

International Nuclear Information System (INIS)

Treuer, Harald

2013-01-01

The proceedings of the medical physics conference 2013 include abstract of lectures and poster sessions concerning the following issues: Tele-therapy - application systems, nuclear medicine and molecular imaging, neuromodulation, hearing and technical support, basic dosimetry, NMR imaging -CEST (chemical exchange saturation transfer), medical robotics, magnetic particle imaging, audiology, radiation protection, phase contrast - innovative concepts, particle therapy, brachytherapy, computerized tomography, quantity assurance, hybrid imaging techniques, diffusion and lung NMR imaging, image processing - visualization, cardiac and abdominal NMR imaging.

Medical education and cognitive continuum theory: an alternative perspective on medical problem solving and clinical reasoning.

Science.gov (United States)

Custers, Eugène J F M

2013-08-01

Recently, human reasoning, problem solving, and decision making have been viewed as products of two separate systems: "System 1," the unconscious, intuitive, or nonanalytic system, and "System 2," the conscious, analytic, or reflective system. This view has penetrated the medical education literature, yet the idea of two independent dichotomous cognitive systems is not entirely without problems.This article outlines the difficulties of this "two-system view" and presents an alternative, developed by K.R. Hammond and colleagues, called cognitive continuum theory (CCT). CCT is featured by three key assumptions. First, human reasoning, problem solving, and decision making can be arranged on a cognitive continuum, with pure intuition at one end, pure analysis at the other, and a large middle ground called "quasirationality." Second, the nature and requirements of the cognitive task, as perceived by the person performing the task, determine to a large extent whether a task will be approached more intuitively or more analytically. Third, for optimal task performance, this approach needs to match the cognitive properties and requirements of the task. Finally, the author makes a case that CCT is better able than a two-system view to describe medical problem solving and clinical reasoning and that it provides clear clues for how to organize training in clinical reasoning.

Validation of a Crowdsourcing Methodology for Developing a Knowledge Base of Related Problem-Medication Pairs

Science.gov (United States)

Wright, A.; Krousel-Wood, M.; Thomas, E. J.; McCoy, J. A.; Sittig, D. F.

2015-01-01

Summary Background Clinical knowledge bases of problem-medication pairs are necessary for many informatics solutions that improve patient safety, such as clinical summarization. However, developing these knowledge bases can be challenging. Objective We sought to validate a previously developed crowdsourcing approach for generating a knowledge base of problem-medication pairs in a large, non-university health care system with a widely used, commercially available electronic health record. Methods We first retrieved medications and problems entered in the electronic health record by clinicians during routine care during a six month study period. Following the previously published approach, we calculated the link frequency and link ratio for each pair then identified a threshold cutoff for estimated problem-medication pair appropriateness through clinician review; problem-medication pairs meeting the threshold were included in the resulting knowledge base. We selected 50 medications and their gold standard indications to compare the resulting knowledge base to the pilot knowledge base developed previously and determine its recall and precision. Results The resulting knowledge base contained 26,912 pairs, had a recall of 62.3% and a precision of 87.5%, and outperformed the pilot knowledge base containing 11,167 pairs from the previous study, which had a recall of 46.9% and a precision of 83.3%. Conclusions We validated the crowdsourcing approach for generating a knowledge base of problem-medication pairs in a large non-university health care system with a widely used, commercially available electronic health record, indicating that the approach may be generalizable across healthcare settings and clinical systems. Further research is necessary to better evaluate the knowledge, to compare crowdsourcing with other approaches, and to evaluate if incorporating the knowledge into electronic health records improves patient outcomes. PMID:26171079

Computerized strain-gauge plethysmography - An alternative method for the detection of lower limb deep venous thrombosis?

Energy Technology Data Exchange (ETDEWEB)

Elford, Julian; Wells, Irving; Cowie, Jim; Hurlock, Carol; Sanders, Hilary

2000-01-01

AIM: To test the ability of computerized strain-gauge plethysmography to act as a screening test for lower limb deep venous thrombosis (DVT). MATERIALS AND METHODS: Over an 8-month period, all patients referred to our Medical Assessment Unit with suspected lower limb DVT were considered for inclusion in the study. Each patient underwent both plethysmography and ascending venography within 24 h, and the presence or absence of thrombus in the popliteal, superficial femoral or iliac veins was noted. The results of the two tests were then used to determine the accuracy of computerized strain-gauge plethysmography in detecting above knee DVT. RESULTS: The screening tests and venograms of 239 patients referred with clinically suspected lower limb DVT were compared. The false negative rate of plethysmography was 15.4%, which is significantly different from the 4.8% claimed by the manufacturers of this device (P = 0.00003). CONCLUSIONS: In a population of acute admissions with suspected lower limb DVT, computerized strain-gauge plethysmography is not suitable for use as a screening test due to an unacceptably high proportion of false negative screens. J. Elford (2000)

Distribution of Problems, Medications and Lab Results in Electronic Health Records: The Pareto Principle at Work.

Science.gov (United States)

Wright, Adam; Bates, David W

2010-01-01

BACKGROUND: Many natural phenomena demonstrate power-law distributions, where very common items predominate. Problems, medications and lab results represent some of the most important data elements in medicine, but their overall distribution has not been reported. OBJECTIVE: Our objective is to determine whether problems, medications and lab results demonstrate a power law distribution. METHODS: Retrospective review of electronic medical record data for 100,000 randomly selected patients seen at least twice in 2006 and 2007 at the Brigham and Women's Hospital in Boston and its affiliated medical practices. RESULTS: All three data types exhibited a power law distribution. The 12.5% most frequently used problems account for 80% of all patient problems, the top 11.8% of medications account for 80% of all medication orders and the top 4.5% of lab result types account for all lab results. CONCLUSION: These three data elements exhibited power law distributions with a small number of common items representing a substantial proportion of all orders and observations, which has implications for electronic health record design.

Computerized axial tomography in the detection of brain damage

International Nuclear Information System (INIS)

Cala, L.A.; Mastaglia, F.L.

1980-01-01

The cranial computerized axial tomography (CAT) findings in groups of patients with epilepsy, migraine, hypertension, and other general medical disorders have been reviewed to assess the frequency and patterns of focal and diffuse brain damage. In addition to demonstrating focal lesions in a proportion of patients with seizures and in patients presenting with a stroke, the CAT scan showed a premature degree of cerebral atrophy in an appreciable proportion of patients with long-standing epilepsy, hypertension and diabetes, and in some patients with migraine, valvular and ischaemic heart disease, chronic obstructive airways disease, and chronic renal failure. The value of CAT as a means of screening for brain damage in groups of individuals at risk is discussed

Break down these barriers to medication safety.

Science.gov (United States)

2009-06-01

Survey says of 2,200 ED nurses from 131 EDs, barriers to complying with medication-related NPSGs are common. Consider additional education of employees. One hospital uses computerized charting system to quicken triage process.

Quality Assessment of Medical Apps that Target Medication-Related Problems.

Science.gov (United States)

Loy, John Shiguang; Ali, Eskinder Eshetu; Yap, Kevin Yi-Lwern

2016-10-01

The advent of smartphones has enabled a plethora of medical apps for disease management. As of 2012, there are 40,000 health care-related mobile apps available in the market. Since most of these medical apps do not go through any stringent quality assessment, there is a risk of consumers being misinformed or misled by unreliable information. In this regard, apps that target medication-related problems (MRPs) are not an exception. There is little information on what constitutes quality in apps that target MRPs and how good the existing apps are. To develop a quality assessment tool for evaluating apps that target MRPs and assess the quality of such apps available in the major mobile app stores (iTunes and Google Play). The top 100 free and paid apps in the medical categories of iTunes and Google Play stores (total of 400 apps) were screened for inclusion in the final analysis. English language apps that targeted MRPs were downloaded on test devices to evaluate their quality. Apps intended for clinicians, patients, or both were eligible for evaluation. The quality assessment tool consisted of 4 sections (appropriateness, reliability, usability, privacy), which determined the overall quality of the apps. Apps that fulfilled the inclusion criteria were classified based on the presence of any 1 or more of the 5 features considered important for apps targeting MRPs (monitoring, interaction checker, dose calculator, medication information, medication record). Descriptive statistics and Mann-Whitney tests were used for analysis. Final analysis was based on 59 apps that fulfilled the study inclusion criteria. Apps with interaction checker (66.9%) and monitoring features (54.8%) had the highest and lowest overall qualities. Paid apps generally scored higher for usability than free apps (P = 0.006) but lower for privacy (P = 0.003). Half of the interaction checker apps were unable to detect interactions with herbal medications. Blood pressure and heart rate monitoring apps

Computerized adaptive testing--ready for ambulatory monitoring?

DEFF Research Database (Denmark)

Rose, Matthias; Bjørner, Jakob; Fischer, Felix

2012-01-01

Computerized adaptive tests (CATs) have abundant theoretical advantages over established static instruments, which could improve ambulatory monitoring of patient-reported outcomes (PROs). However, an empirical demonstration of their practical benefits is warranted.......Computerized adaptive tests (CATs) have abundant theoretical advantages over established static instruments, which could improve ambulatory monitoring of patient-reported outcomes (PROs). However, an empirical demonstration of their practical benefits is warranted....

PADS (Patient Archiving and Documentation System): a computerized patient record with educational aspects.

Science.gov (United States)

Hohnloser, J H; Pürner, F

1992-01-01

Rapid acquisition and analysis of information in an Intensive Care Unit (ICU) setting is essential, even more so the documentation of the decision making process which has vital consequences for the lives of ICU patients. We describe an Ethernet based local area network (LAN) with clinical workstations (Macintosh fx, ci). Our Patient Archiving and Documentation System (PADS) represents a computerized patient record presently used in a university hospitals' ICU. Taking full advantage of the Macintosh based graphical user interface (GUI) our system enables nurses and doctors to perform the following tasks: admission, medical history taking, physical examination, generation of problem lists and follow up notes, access to laboratory data and reports, semiautomatic generation of a discharge summary including full word processor capabilities. Furthermore, the system offers rapid, consistent and complete automatic encoding of diagnoses following the International Classification of Disease (ICD; WHO, [1]). For educational purposes the user can also view disease entities or complications related to the diagnoses she/he encoded. The system has links to other educational programs such as cardiac auscultation. A MEDLINE literature search through a CD-ROM based system can be performed without exiting the system; also, CD-ROM based medical textbooks can be accessed as well. Commercially available Macintosh programs can be integrated in the system without existing the main program thus enabling users to customize their working environment. Additional options include automatic background monitoring of users learning behavior, analyses and graphical display of numerous epidemiological and health care related problems. Furthermore, we are in the process of integrating sound and digital video in our system. This system represents one in a line of modular departmental models which will eventually be integrated to form a decentralized Hospital Information System (HIS).

Computerized data base of the fundamental constants of nature

International Nuclear Information System (INIS)

Henry, E.A.; Hampel, V.E.

1975-01-01

Fifty-seven fundamental constants of nature were computerized from the up-to-date evaluations of E. R. Cohen and B. N. Taylor. The constants are annotated with regard to symbol, value, uncertainty, and scaling factor. This computerization is part of the scientific data base project of the Information Research Group at Lawrence Livermore Laboratory. The MASTER CONTROL data base management system is used. The computerized fundamental constants can be requested from the ERDA Computer Program Exchange and Information Center of the Argonne National Laboratory or from the National Technical Information Service of the U. S. Department of Commerce. This is the first of a series of releases on preparation of computerized scientific and technological data banks. The next release is a data bank of conversion factors for different units of measurements. 3 figures

Occupational medical prophylaxis for the musculoskeletal system: A function-oriented system for physical examination of the locomotor system in occupational medicine (fokus(C

Directory of Open Access Journals (Sweden)

Schwarze Sieglinde

2007-10-01

Full Text Available Abstract Occupational physicians are very often confronted with questions as to the fitness of the postural and locomotor systems, especially the spinal column. Occupational medical assessment and advice can be required by patients with acute symptoms, at routine check-ups, by persons who have problems doing certain jobs, and for expert medical reports as to the fitness of persons with chronic disorders or after operations. Therefore, for occupational medical purposes a physical examination must aim primarily to investigate functions and not structures or radiologic evidence. The physical examination should be structured systematically and according to regions of the body and, together with a specific (pain anamnesis should provide a basis for the medical assessment. This paper presents a function-oriented system for physical examination of the locomotor system, named fokus(C (Funktionsorientierte Koerperliche Untersuchungssystematik, also available on DVD. fokus(C has been developed with a view to its relevance for occupational medical practice and does not aim primarily to provide a precise diagnosis. Decisive for an occupational medical assessment of disorders of the musculoskeletal system is rather information about functional disorders and any impairment of performance or mobility which they can cause. The division of the physical examination into a rapid screening phase and a subsequent more intensive functional diagnostic phase has proved its practicability in many years of day-to-day use. Here, in contrast to the very extensive measures recommended for orthopaedic and manual diagnosis, for reasons of efficiency and usability of the system in routine occupational medical examinations the examination is structured according to the findings. So it is reduced to that which is most necessary and feasible.

Research-oriented medical education for graduate medical students.

Science.gov (United States)

Deo, Madhav G

2013-01-01

In most parts of the world, medical education is predominantly geared to create service personnel for medical and health services. Training in research is ignored, which is a major handicap for students who are motivated to do research. The main objective of this study was to develop, for such students, a cost-effective 'in-study' research training module that could be adopted even by medical colleges, which have a modest research infrastructure, in different regions of India. Short-duration workshops on the clinical and laboratory medicine research methods including clinical protocol development were held in different parts of India to facilitate participation of students from various regions. Nine workshops covering the entire country were conducted between July 2010 and December 2011. Participation was voluntary and by invitation only to the recipients of the Indian Council of Medical Research-Short-term Studentship programme (ICMR- STS), which was taken as an index of students' research motivation. Faculty was drawn from the medical institutions in the region. All expenses on students, including their travel, and that of the faculty were borne by the academy. Impact of the workshop was judged by the performance of the participants in pre- and post-workshop tests with multiple-choice questions (MCQs) containing the same set of questions. There was no negative marking. Anonymous student feedback was obtained using a questionnaire. Forty-one per cent of the 1009 invited students attended the workshops. These workshops had a positive impact on the participants. Only 20% students could pass and just 2.3% scored >80% marks in the pre-workshop test. There was a three-fold increase in the pass percentage and over 20% of the participants scored >80% marks (A grade) in the post-workshop test. The difference between the pre- and post- workshop performance was statistically significant at all the centres. In the feedback from participants, the workshop received an average

Risk-oriented management of system configurations during power plant operation

International Nuclear Information System (INIS)

Kafka, P.

1991-01-01

The paper explains the purpose, design, and functions of an on-line database called risk monitor, which is developed on the basis of a risk model mapping an entire plant and the functions of the system configurations by a probabilistic and risk-oriented approach in a computerized simulation model. The frequency of occurrence of the various failure modes is computed and specified by fault tree analysis and event tree analysis. The monitoring system is a diagnostic tool for power plant operators. (DG) [de

Distributed Computerized Catalog System

Science.gov (United States)

Borgen, Richard L.; Wagner, David A.

1995-01-01

DarkStar Distributed Catalog System describes arbitrary data objects in unified manner, providing end users with versatile, yet simple search mechanism for locating and identifying objects. Provides built-in generic and dynamic graphical user interfaces. Design of system avoids some of problems of standard DBMS, and system provides more flexibility than do conventional relational data bases, or object-oriented data bases. Data-collection lattice partly hierarchical representation of relationships among collections, subcollections, and data objects.

Ethical orientation, functional linguistics, and the codes of ethics of the Canadian Nurses Association and the Canadian Medical Association.

Science.gov (United States)

Hadjistavropoulos, Thomas; Malloy, David C; Douaud, Patrick; Smythe, William E

2002-09-01

The literature on codes of ethics suggests that grammatical and linguistic structures as well as the theoretical ethical orientation conveyed in codes of ethics have implications for the manner in which such codes are received by those bound by them. Certain grammatical and linguistic structures, for example, tend to have an authoritarian and disempowering impact while others can be empowering. The authors analyze and compare the codes of ethics of the Canadian Nurses Association (CNA) and the Canadian Medical Association (CMA) in terms of their ethical orientation and grammatical/linguistic structures. The results suggest that the two codes differ substantially along these two dimensions. The CNA code contains proportionally more statements that provide a rationale for ethical behaviour; the statements of the CMA code tend to be more dogmatic. Functional grammar analysis suggests that both codes convey a strong deontological tone that does not enhance the addressee's ability to engage in discretionary decision-making. The nurses' code nonetheless implies a collaborative relationship with the client, whereas the medical code implies that the patient is the recipient of medical wisdom. The implications of these findings are discussed.

Computerized videodefecography versus defecography: do we need radiographs?

Directory of Open Access Journals (Sweden)

Carlos Walter Sobrado

Full Text Available CONTEXT AND OBJECTIVE: Defecography has been recognized as a valuable method for evaluating patients with evacuation disorders. It consists of the use of static radiography and fluoroscopy to record different situations within anorectal dynamics. Conventionally, rectal parameters are measured using radiograms. It is rare for fluoroscopy alone to be used. Computer software has been developed with the specific aim of calculating these measurements from digitized videotaped images obtained during fluoroscopy, without the need for radiographic film, thereby developing a computerized videodefecography method. The objective was thus to compare measurements obtained via computerized videodefecography with conventional measurements and to discuss the advantages of the new method. DESIGN AND SETTING: Prospective study at the radiology service of Hospital das Clínicas, Universidade de São Paulo. METHOD: Ten consecutive normal subjects underwent videodefecography. The anorectal angle, anorectal junction, puborectalis muscle length, anal canal length and degree of anal relaxation were obtained via the conventional method (using radiography film and via computerized videodefecography using the ANGDIST software. Measurement and analysis of these parameters was performed by two independent physicians. RESULTS: Statistical analysis confirmed that the measurements obtained through direct radiography film assessment and using digital image analysis (computerized videodefecography were equivalent. CONCLUSIONS: Computerized videodefecography is equivalent to the traditional defecography examination. It has the advantage of offering reduced radiation exposure through saving on the use of radiography.

Highly resolving computerized tomography

International Nuclear Information System (INIS)

Kurtz, B.; Petersen, D.; Walter, E.

1984-01-01

With the development of highly-resolving devices for computerized tomography, CT diagnosis of the lumbar vertebral column has gained increasing importance. As an ambulatory, non-invasive method it has proved in comparative studies to be at least equivalent to myelography in the detection of dislocations of inter-vertebral disks (4,6,7,15). Because with modern devices not alone the bones, but especially the spinal soft part structures are clearly and precisely presented with a resolution of distinctly below 1 mm, a further improvement of the results is expected as experience will increase. The authors report on the diagnosis of the lumbar vertebral column with the aid of a modern device for computerized tomography and wish to draw particular attention to the possibility of doing this investigation as a routine, and to the diagnostic value of secondary reconstructions. (BWU) [de

Highly resolving computerized tomography

Energy Technology Data Exchange (ETDEWEB)

Kurtz, B.; Petersen, D.; Walter, E.

1984-01-01

With the development of highly-resolving devices for computerized tomography, CT diagnosis of the lumbar vertebral column has gained increasing importance. As an ambulatory, non-invasive method it has proved in comparative studies to be at least equivalent to myelography in the detection of dislocations of inter-vertebral disks (4,6,7,15). Because with modern devices not alone the bones, but especially the spinal soft part structures are clearly and precisely presented with a resolution of distinctly below 1 mm, a further improvement of the results is expected as experience will increase. The authors report on the diagnosis of the lumbar vertebral column with the aid of a modern device for computerized tomography and wish to draw particular attention to the possibility of doing this investigation as a routine, and to the diagnostic value of secondary reconstructions.

A trial of patient-oriented problem-solving system for immunology teaching in China: a comparison with dialectic lectures

OpenAIRE

Zhang Zhiren; Liu Wei; Han Junfeng; Guo Sheng; Wu Yuzhang

2013-01-01

Abstract Background The most common teaching method used in China is lecturing, but recently, efforts have been widely undertaken to promote the transition from teacher-centered to student-centered education. The patient-oriented problem-solving (POPS) system is an innovative teaching-learning method that permits students to work in small groups to solve clinical problems, promotes self-learning, encourages clinical reasoning and develops long-lasting memory. To our best knowledge, however, P...

Problems of cranial computer-tomography

Energy Technology Data Exchange (ETDEWEB)

Seitz, D [Allgemeines Krankenhaus St. Georg, Hamburg (Germany, F.R.). Neurologische Abt.

1979-07-01

The author discusses the problems that have cropped up since the introduction of computerized tomography 5 years ago. To begin with, problems of contrast and object resolution are discussed with a special view to the importance of amipague imaging of cisterns, in particular in the detection of basal growing and displacing, intracranial processes. After this, the tasks of computerized tomography in neurological and neurosurgical emergencies, cerebrocranial injuries, cerebral circulation disturbances, inflammatory diseases of the central nervous systems, epileptic seizures, and chronical headaches are reviewed. Special regard is given to the problem of recurrent examinations and course control, especially in cerebral tumours and aresorptive hydrocephalus. Another paragraph deals with the correlation between CT findings, clinical symptoms, and clinical findings. The importance of cranial CT for neurological diagnoses is illustrated by the change of indications for conventional methods of examination. The limits of the method are shown and it is pointed out that cranial CT is not a search technique but that it requires previous examinations by a neurologist, neurosurgeon, or neuropaediatrician.

Problems of cranial computer-tomography

International Nuclear Information System (INIS)

Seitz, D.

1979-01-01

The author discusses the problems that have cropped up since the introduction of computerized tomography 5 years ago. To begin with, problems of contrast and object resolution are discussed with a special view to the importance of amipague imaging of cisterns, in particular in the detection of basal growing and displacing, intracranial processes. After this, the tasks of computerized tomography in neurological and neurosurgical emergencies, cerebrocranial injuries, cerebral circulation disturbances, inflammatory diseases of the central nervous systems, epileptic seizures, and chronical headaches are reviewed. Special regard is given to the problem of recurrent examinations and course control, especially in cerebral tumours and aresorptive hydrocephalus. Another paragraph deals with the correlation between CT findings, clinical symptoms, and clinical findings. The importance of cranial CT for neurological diagnoses is illustrated by the change of indications for conventional methods of examination. The limits of the method are shown and it is pointed out that cranial CT is not a search technique but that it requires previous examinations by a neurologist, neurosurgeon, or neuropaediatrician. (orig.) [de

An implementation of wireless medical image transmission system on mobile devices.

Science.gov (United States)

Lee, SangBock; Lee, Taesoo; Jin, Gyehwan; Hong, Juhyun

2008-12-01

The advanced technology of computing system was followed by the rapid improvement of medical instrumentation and patient record management system. The typical examples are hospital information system (HIS) and picture archiving and communication system (PACS), which computerized the management procedure of medical records and images in hospital. Because these systems were built and used in hospitals, doctors out of hospital have problems to access them immediately on emergent cases. To solve these problems, this paper addressed the realization of system that could transmit the images acquired by medical imaging systems in hospital to the remote doctors' handheld PDA's using CDMA cellular phone network. The system consists of server and PDA. The server was developed to manage the accounts of doctors and patients and allocate the patient images to each doctor. The PDA was developed to display patient images through remote server connection. To authenticate the personal user, remote data access (RDA) method was used in PDA accessing the server database and file transfer protocol (FTP) was used to download patient images from the remove server. In laboratory experiments, it was calculated to take ninety seconds to transmit thirty images with 832 x 488 resolution and 24 bit depth and 0.37 Mb size. This result showed that the developed system has no problems for remote doctors to receive and review the patient images immediately on emergent cases.

The Role of Parents' Attachment Orientations, Depressive Symptoms, and Conflict Behaviors in Children's Externalizing and Internalizing Behavior Problems

Science.gov (United States)

Marchand, Jennifer F.; Schedler, Steven; Wagstaff, David A.

2004-01-01

The present study examined links among parents' attachment orientations, depressive symptoms, and conflict behaviors (attacking and compromising) and children's externalizing and internalizing behavior problems in a sample of 64 nonclinical, Caucasian families. Correlational analyses showed that all three parent attributes were significantly…

Medical record management systems: criticisms and new perspectives.

Science.gov (United States)

Frénot, S; Laforest, F

1999-06-01

The first generation of computerized medical records stored the data as text, but these records did not bring any improvement in information manipulation. The use of a relational database management system (DBMS) has largely solved this problem as it allows for data requests by using SQL. However, this requires data structuring which is not very appropriate to medicine. Moreover, the use of templates and icon user interfaces has introduced a deviation from the paper-based record (still existing). The arrival of hypertext user interfaces has proven to be of interest to fill the gap between the paper-based medical record and its electronic version. We think that further improvement can be accomplished by using a fully document-based system. We present the architecture, advantages and disadvantages of classical DBMS-based and Web/DBMS-based solutions. We also present a document-based solution and explain its advantages, which include communication, security, flexibility and genericity.

Computerized tomography in evaluation of the pulmonary hilum

International Nuclear Information System (INIS)

Secaf, M.; Ferreira, J.L.N.; Secaf, E.

1987-01-01

The use of computerized tomography as a method for evaluating the pulmonary hilum and its application in the diagnosis of endobronchial lesions, hilar masss, contiguous involvement of the mediastinum by hilar mass, and vascular hilar lesions are discussed. A comparative evaluation between conventional tomograms and computerized tomography is presented. (M.A.C.) [pt

Medication use in children with asthma: not a child size problem.

Science.gov (United States)

Grover, Charu; Armour, Carol; Asperen, Peter Paul Van; Moles, Rebekah; Saini, Bandana

2011-12-01

The global burden of pediatric asthma is high. Governments and health-care systems are affected by the increasing costs of childhood asthma--in terms of direct health-care costs and indirect costs due to loss of parental productivity, missed school days, and hospitalizations. Despite the availability of effective treatment, the current use of medications in children with asthma is suboptimal. The purpose of this review is to scope the empirical literature to identify the problems associated with the use of pediatric asthma medications. The findings will help to design interventions aiming to improve the use of asthma medications among children. A literature search using electronic search engines (i.e., Medline, International Pharmaceutical Abstracts (IPA), PubMed, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature (CINAHL)) and the search terms "asthma," "children," and "medicines" (and derivatives of these keywords) was conducted. The search terms were expanded to include emergent themes arising out of search findings. Content themes relating to parents, children themselves, health-care professionals, organizational systems, and specific medications and devices were found. Within these themes, key issues included a lack of parental knowledge about asthma and asthma medications, lack of information provided to parents, parental beliefs and fears, parental behavioral problems, the high costs of medications and devices, the child's self-image, the need for more child responsibility, physician nonadherence to prescribing guidelines, "off-label" prescribing, poor understanding of teachers, lack of access to educational resources, and specific medications. These key issues should be taken into account when modifying the development of educational tools. These tools should focus on targeting the children themselves, the parent/carers, the health-care professionals, and various organizational systems.

Teaching Biochemistry at a Medical Faculty with a Problem-Based Learning System.

Science.gov (United States)

Rosing, Jan

1997-01-01

Highlights the differences between classical teaching methods and problem-based learning. Describes the curriculum and problem-based approach of the Faculty of Medicine at the Maastricht University and gives an overview of the implementation of biochemistry in the medical curriculum. Discusses the procedure for student assessment and presents…

A renewed Medication Adherence Alliance call to action: harnessing momentum to address medication nonadherence in the United States

Directory of Open Access Journals (Sweden)

Zullig LL

2016-07-01

Full Text Available Leah L Zullig,1,2 Bradi B Granger,3 Hayden B Bosworth,1–4 On behalf of the Medication Adherence Alliance 1Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 2Division of General Internal Medicine, Department of Medicine, Duke University, 3Duke Heart Center Nursing Research Program, School of Nursing, Duke University, 4Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA The problem: Nonadherence to prescription medications is a common and costly problem with multiple contributing factors, spanning the dimensions of individual behavior change, psychology, medicine, and health policy, among others. Addressing the problem of medication nonadherence requires strategic input from key experts in a number of fields.Meeting of experts: The Medication Adherence Alliance is a group of key experts, predominately from the US, in the field of medication nonadherence. Members include representatives from consumer advocacy groups, community health providers, nonprofit groups, the academic community, decision-making government officials, and industry. In 2015, the Medication Adherence Alliance convened to review the current landscape of medication adherence. The group then established three working groups that will develop recommendations for shifting toward solutions-oriented science.Commentary of expert opinion: From the perspective of the Medication Adherence Alliance, the objective of this commentary is to describe changes in the US landscape of medication adherence, framing the evolving field in the context of a recent think tank meeting of experts in the field of medication adherence. Keywords: medication adherence, health planning recommendations, chronic disease

The use of PROLOG for computerized Technical Specifications

International Nuclear Information System (INIS)

Lidsky, L.M.; Lanning, D.D.; Dobrzeniecki, A.B.; Meyers, K.; Reese, T.G.

1987-01-01

The task of deciding whether a particular nuclear plant condition is in compliance with its Technical Specifications is, in principle, algorithmic. However, the implicit algorithm is so complex and the required level of confidence in code validity is so high that traditional methods of computerized analysis have proven unsatisfactory. PROLOG provides a close match to the explicit semantic structure of the written specifications, a good tool for analysis of the implicit subsystem operability trees and, by virtue of its declarative style and imbedded logical structure, greatly simplifies the problem of code validation. LCOM, a PROLOG representation of a subset of BWR Technical Specifications, was developed to explore the applicability of PROLOG in this problem domain and to provide benchmark data for full-scale implementations. The declarative style and built-in unification mechanism of PROLOG does substantially simplify the process of program construction and validation. Extrapolations indicate processing times for a complete Tech Spec implementation of ≤ 1 minute in systems capable of ≥ 20 KLIPS

[Current teaching, learning and examination methods in medical education and potential applications in rehabilitative issues].

Science.gov (United States)

Schwarzkopf, S R; Morfeld, M; Gülich, M; Lay, W; Horn, K; Mau, W

2007-04-01

With introduction of the new Federal Medical Licensing Regulations (Approbationsordnung) in Germany, integrated teaching in "Rehabilitation, Physical Medicine, Naturopathic Treatment" (Querschnittsbereich Q12) has become obligatory for the first time. Furthermore, the new Regulations require the medical faculties in Germany to realize an innovative didactic orientation in teaching. This paper provides an overview of recent applications of teaching techniques and examination methods in medical education with special consideration of the new integrated course Q12 and further teaching methods related to rehabilitative issues. Problem-oriented learning (POL), problem-based learning (PBL), bedside teaching, eLearning, and the examination methods Objective Structured Clinical Examination (OSCE) and Triple Jump are in the focus. This overview is intended as the basis for subsequent publications of the Commission for Undergraduate and Postgraduate Training of the German Society of Rehabilitation Science (DGRW), which will present examples of innovative teaching material.

Orientation effects on indexing of electron backscatter diffraction patterns

International Nuclear Information System (INIS)

Nowell, Matthew M.; Wright, Stuart I.

2005-01-01

Automated Electron Backscatter Diffraction (EBSD) has become a well-accepted technique for characterizing the crystallographic orientation aspects of polycrystalline microstructures. At the advent of this technique, it was observed that patterns obtained from grains in certain crystallographic orientations were more difficult for the automated indexing algorithms to accurately identify than patterns from other orientations. The origin of this problem is often similarities between the EBSD pattern of the correct orientation and patterns from other orientations or phases. While practical solutions have been found and implemented, the identification of these problem orientations generally occurs only after running an automated scan, as problem orientations are often readily apparent in the resulting orientation maps. However, such an approach only finds those problem orientations that are present in the scan area. It would be advantageous to identify all regions of orientation space that may present problems for automated indexing prior to initiating an automated scan, and to minimize this space through the optimization of acquisition and indexing parameters. This work presents new methods for identifying regions in orientation space where the reliability of the automated indexing is suspect prior to performing a scan. This methodology is used to characterize the impact of various parameters on the indexing algorithm

Celebral computerized tomography

International Nuclear Information System (INIS)

Lofteroed, B.; Sortland, O.

1985-01-01

Indications for cerebral computerized tomography (CT) and the diagnostic results from this examination are evaluated in 127 children. Pathological changes were found in 31 children, mostly based on such indications as increasing head size, suspicion of brain tumor, cerebral paresis, delayed psychomotor development and epileptic seizures. A list of indications for CT in children is given

Feasibility of a computerized intervention for offenders with substance use disorders: a research note.

Science.gov (United States)

Chaple, Michael; Sacks, Stanley; McKendrick, Karen; Marsch, Lisa A; Belenko, Steven; Leukefeld, Carl; Prendergast, Michael; French, Michael

2014-01-01

Despite evidence that treatment is effective in reducing recidivism among inmates with substance use problems, scarce resources mean that few of those in need of treatment actually receive it. Computerized substance abuse interventions could be used to expand access to treatment in prisons without placing an undue burden on resources. The major aim of the study was to compare treatment conditions in terms of their service utilization, skills acquisition, and treatment satisfaction. The study recruited men and women with substance use disorders from 10 prisons in 4 states. In an open label clinical trial, 494 subjects were randomly assigned either to the Experimental condition, a computerized drug treatment intervention, the Therapeutic Education System (TES; n  = 249), or to the Control condition, Standard Care ( n  = 245). Chi-square tests compared groups on categorical variables and independent samples t tests were used for interval level continuous variables. Initial evidence demonstrated: (1) comparable group rates of session attendance and high rates of TES module completion for experimental subjects; (2) comparable group gains in the development of coping skills; and (3) a more favorable view of TES than of Standard Care . Collectively, these results show that a computerized intervention, such as TES, can be implemented successfully in prison. Given the barriers to the delivery of substance abuse treatment typically encountered in correctional settings, computerized interventions have the potential to fill a significant treatment gap and are particularly well suited to inmates with mild to moderate substance use disorders who often are not treated.

Computerized tomography of the brain and associated risk factors in 240 patients iwth reversible cerebral ischemic attacks (RIAs)

International Nuclear Information System (INIS)

Bozzao, L.; Fantozzi, L.M.; Carolei, A.; Pappata, S.; Vesentini, G.; Allori, L.; Rasura, M.; Fieschi, C.

1985-01-01

The frequency and distribution of focal low density cerebral ischemic lesions in RIA patients with regard to factors as age at onset, number and temporal profile of the reversible cerebral ischemic events on admission, presence of associated medical conditions such as hypertension and diabetes mellitus, have been investigated with computerized tomography of the brain. (author). 7 refs.; 1 tab

Dialog about Psychosocial Issues in Problem-Based Learning Sessions in Medical Education

Science.gov (United States)

Adams, Nancy E.

2016-01-01

The purpose of this qualitative case study was two-fold: to investigate the dialog about psychosocial aspects of health care in problem based learning (PBL) groups in a single medical school; and to describe the factors that learners and PBL facilitators identify as influencing dialog about these issues in PBL groups. Medical education is a…

Examinations and patient management in radiologic diagnostics by means of a computerized data-processing communications system

International Nuclear Information System (INIS)

Klotz, E.; Remplik, V.; Opfer, M.; Wilde, E.

1986-01-01

Concept, realization and a two-year experience in routine use of a computerized data-processing communications system supporting the central radiology department in a 1.625-bed, municipal hospital are discussed. Via the hospital ward-linked terminal network, routine X-ray examination is so ordered, that individual medical case information is provided, which certifies qualified clinical and diagnostic procedure along with good patient preparation and transportation. Complete information and documentation are also ensured. It was shown, that good motivation among involved radiologists and their close working-association with other departments are mandatory from the start to maintain exact time schedules and satisfactory completion of ordered X-ray procedures. Subsequently, the assistance through computerized data-processing becomes an accepted help - so far as it is appropriately used - as time goes by in its routine use. (orig.) [de

Visibility-Based Goal Oriented Metrics and Application to Navigation and Path Planning Problems

Science.gov (United States)

2017-12-14

Oriented Metrics and Application to Navigation and Path Planning Problems Report Term: 0-Other Email : ytsai@math.utexas.edu Distribution Statement: 1...error bounds that we have obtained. Report Date: 06-Dec-2017 INVESTIGATOR(S): Phone Number: 5122327757 Principal: Y Name: Yen-Hsi Tsai Email ...w1 w2 ◆ and ~z = ✓ z1 z2 ◆ . Then we can write D0 h (PN (xi,j)) = Rp (R+⌘)2+h2 + 1 2h (µ2w1 µ2z1) 0 µ2w2µ3z2 2h 0 ! . It follows that the non

Computerized accounting methods. Final report

International Nuclear Information System (INIS)

1994-01-01

This report summarizes the results of the research performed under the Task Order on computerized accounting methods in a period from 03 August to 31 December 1994. Computerized nuclear material accounting methods are analyzed and evaluated. Selected methods are implemented in a hardware-software complex developed as a prototype of the local network-based CONMIT system. This complex has been put into trial operation for test and evaluation of the selected methods at two selected ''Kurchatov Institute'' Russian Research Center (''KI'' RRC) nuclear facilities. Trial operation is carried out since the beginning of Initial Physical Inventory Taking in these facilities that was performed in November 1994. Operation of CONMIT prototype system was demonstrated in the middle of December 1994. Results of evaluation of CONMIT prototype system features and functioning under real operating conditions are considered. Conclusions are formulated on the ways of further development of computerized nuclear material accounting methods. The most important conclusion is a need to strengthen computer and information security features supported by the operating environment. Security provisions as well as other LANL Client/Server System approaches being developed by Los Alamos National Laboratory are recommended for selection of software and hardware components to be integrated into production version of CONMIT system for KI RRC

Medication management and practices in prison for people with mental health problems: a qualitative study

OpenAIRE

Bowen, Robert A; Rogers, Anne; Shaw, Jennifer

2009-01-01

Abstract Background Common mental health problems are prevalent in prison and the quality of prison health care provision for prisoners with mental health problems has been a focus of critical scrutiny. Currently, health policy aims to align and integrate prison health services and practices with those of the National Health Service (NHS). Medication management is a key aspect of treatment for patients with a mental health problem. The medication practices of patients and staff are therefore ...

Safeguarding nuclear materials in the former Soviet Republics through computerized materials protection, control and accountability

International Nuclear Information System (INIS)

Roumiantsev, A.N.; Ostroumov, Y.A.; Whiteson, R.; Seitz, S.L.; Landry, R.P.; Martinez, B.J.; Boor, M.G.; Anderson, L.K.; Gary, S.P.

1997-01-01

The threat of nuclear weapons proliferation is a problem of global concern. International efforts at nonproliferation focus on preventing acquisition of weapons-grade nuclear materials by unauthorized states, organizations, or individuals. Nonproliferation can best be accomplished through international cooperation in the application of advanced science and technology to the management and control of nuclear materials. Computerized systems for nuclear material protection, control, and accountability (MPC and A) are a vital component of integrated nuclear safeguards programs. This paper describes the progress of scientists in the United States and former Soviet Republics in creating customized, computerized MPC and A systems. The authors discuss implementation of the Core Material Accountability System (CoreMAS), which was developed at Los Alamos National Laboratory by the US Department of Energy and incorporates, in condensed and integrated form, the most valuable experience gained by US nuclear enterprises in accounting for and controlling nuclear materials. The CoreMAS approach and corresponding software package have been made available to sites internationally. CoreMAS provides methods to evaluate their existing systems and to examine advantages and disadvantages of customizing CoreMAS or improving their own existing systems. The sites can also address crucial issues of software assurance, data security, and system performance; compare operational experiences at sites with functioning computerized systems; and reasonably evaluate future efforts. The goal of the CoreMAS project is to introduce facilities at sites all over the world to modern international MPC and A practices and to help them implement effective, modern, computerized MPC and A systems to account for their nuclear materials, and thus reduce the likelihood of theft or diversion. Sites are assisted with MPC and A concepts and the implementation of an effective computerized MPC and A system

First experience with a mobile computed tomograph in the USSR

International Nuclear Information System (INIS)

Portnoj, L.M.

1989-01-01

Utilization experience of mobile computerized tomograph mounted in the bus is presented. Problems concerning staff, selection of medical base institutes etc are considered. Efficiency of mobile computerized tomographes in revealing different diseases is pointed out

Aspect-Oriented Programming

NARCIS (Netherlands)

Bergmans, Lodewijk; Videira Lopes, Cristina; Moreira, Ana; Demeyer, Serge

1999-01-01

Aspect-oriented programming is a promising idea that can improve the quality of software by reduce the problem of code tangling and improving the separation of concerns. At ECOOP'97, the first AOP workshop brought together a number of researchers interested in aspect-orientation. At ECOOP'98, during

Pharmaceutical orientation at hospital discharge of transplant patients: strategy for patient safety.

Science.gov (United States)

Lima, Lívia Falcão; Martins, Bruna Cristina Cardoso; Oliveira, Francisco Roberto Pereira de; Cavalcante, Rafaela Michele de Andrade; Magalhães, Vanessa Pinto; Firmino, Paulo Yuri Milen; Adriano, Liana Silveira; Silva, Adriano Monteiro da; Flor, Maria Jose Nascimento; Néri, Eugenie Desirée Rabelo

2016-01-01

To describe and analyze the pharmaceutical orientation given at hospital discharge of transplant patients. This was a cross-sectional, descriptive and retrospective study that used records of orientation given by the clinical pharmacist in the inpatients unit of the Kidney and Liver Transplant Department, at Hospital Universitário Walter Cantídio, in the city of Fortaleza (CE), Brazil, from January to July, 2014. The following variables recorded at the Clinical Pharmacy Database were analyzed according to their significance and clinical outcomes: pharmaceutical orientation at hospital discharge, drug-related problems and negative outcomes associated with medication, and pharmaceutical interventions performed. The first post-transplant hospital discharge involved the entire multidisciplinary team and the pharmacist was responsible for orienting about drug therapy. The mean hospital discharges/month with pharmaceutical orientation during the study period was 10.6±1.3, totaling 74 orientations. The prescribed drug therapy had a mean of 9.1±2.7 medications per patient. Fifty-nine drug-related problems were identified, in which 67.8% were related to non-prescription of medication needed, resulting in 89.8% of risk of negative outcomes associated with medications due to untreated health problems. The request for inclusion of drugs (66.1%) was the main intervention, and 49.2% of the medications had some action in the digestive tract or metabolism. All interventions were classified as appropriate, and 86.4% of them we able to prevent negative outcomes. Upon discharge of a transplanted patient, the orientation given by the clinical pharmacist together with the multidisciplinary team is important to avoid negative outcomes associated with drug therapy, assuring medication reconciliation and patient safety. Descrever e analisar a orientação farmacêutica oferecida na alta de pacientes transplantados. Trata-se de um estudo transversal, descritivo e retrospectivo, que

Information technologies at physics practicums in a subject-oriented school

Directory of Open Access Journals (Sweden)

Tishchenko Lyudmila V.

2016-01-01

Full Text Available The paper suggests a new method of implementing an activity approach in a physicsoriented program. Such method implies the use of a system which comprises three types of practical sessions: a laboratory practicum, a practical training aimed at analyzing physical processes on the basis of computerized modeling and a problem-solving practicum. A methodology used for holding practicums provides for an active use of information technologies. At laboratory sessions we use computerized sensors, tablets with an integrated data recorder, an electronic oscilloscope and process data in Excel tables. At practicums aimed at analyzing physical processes, we develop programs in Visual Basic and Рascal in order to visualize physical processes in the form of motion trajectories, dynamic charts; besides, we conduct computer experiments. At problem-solving practicums we use our own PowerPoint “Study Guide for an Interactive Whiteboard”, which contains a database of graphic and pictorial physics problems for students of 10–11 grades. Knowledge of information technologies facilitates students’ adaptation in modern society, improves education quality.

Problems of nuclear reactor safety. Vol. 1

International Nuclear Information System (INIS)

Shal'nov, A.V.

1995-01-01

Proceedings of the 9. Topical Meeting 'Problems of nuclear reactor safety' are presented. Papers include results of studies and developments associated with methods of calculation and complex computerized simulation for stationary and transient processes in nuclear power plants. Main problems of reactor safety are discussed as well as rector accidents on operating NPP's are analyzed

Medical support of children’s sports: Topical problems

Directory of Open Access Journals (Sweden)

L. A. Balykova

2017-01-01

Full Text Available The paper discusses the most topical issues of medical support of children and adolescents engaged in physical exercises and sports. Much attention is paid to different views on the etiology, pathogenesis, diagnosis, and principles of therapy of pathological transformation of the heart in child athletes. The problem of sudden cardiac death in sports and the possibility of a relationship between connective tissue dysplasia and its development are touched upon. Electrocardiographic and morphological criteria for cardiac maladaptation in athletes are discussed. The problem of early and accessible diagnosis and Russia’s tactics for the diagnosis of health changes in athletes and approaches to their prevention and treatment are covered. Different ways to prevent the pathological transformation of the cardiovascular system in athletes and sudden cardiac death as its extreme manifestation are discussed.

Computerized management of plant intervention tasks

International Nuclear Information System (INIS)

Remacle, J.; Quoidbach, G.

1993-01-01

The concept of 'computerized management' of plant intervention tasks was developed by TRACTEBEL in 1983 for the Belgian power plants of ELECTRABEL. The main objective of the 'Computerized Management of Plant Intervention Tasks' is to help the staff of a nuclear or a conventional power plant in planning, organizing, and carrying out any (preventive or corrective) maintenance task. It consists of a group of interconnected functional modules acting on a unique and homogeneous data base. A short description of 3 modules is given, i.e., the 'User' Module, the 'Equipment' Module and the 'Periodic Procedure' Module. (Z.S.)

Developing the Medication Reminder Mobile Application "Seeb".

Science.gov (United States)

Saghaeiannejad-Isfahani, Sakineh; Ehteshami, Asghar; Savari, Ebtesam; Samimi, Ali

2017-06-01

Today, the structure of comprehensive health care emphasizes self-care more than therapy. Medication therapy is a strong instrument for therapy received through the health setting, especially in medication area. Error in medication administration has produced different problems and they cost billions of dollars every year. Regarding mobile phone extensions, we developed a local medication reminder mobile application called "Seeb" as a suitable solution for decreasing medication errors for Iranians. We conducted a mixed methods study in three Phases: 1) Comparative study of existing mobile applications; 2) developed its object-oriented model; 3) Developed the initial version of "Seeb" that was approved for production. This application was designed for the appropriate medication administration including time and dosages through: recording patient and medication data; scheduling patients' medication; and reporting medication administration on progress. "Seeb" has been designed in compliance with Iranian health information technologists and pharmacists requirements. It is expected to reduce medication error and improve patient adherence to medical prescriptions.

Student performance and their perception of a patient-oriented problem-solving approach with audiovisual aids in teaching pathology: a comparison with traditional lectures

Directory of Open Access Journals (Sweden)

Arjun Singh

2010-12-01

Full Text Available Arjun SinghDepartment of Pathology, Sri Venkateshwara Medical College Hospital and Research Centre, Pondicherry, IndiaPurpose: We use different methods to train our undergraduates. The patient-oriented problem-solving (POPS system is an innovative teaching–learning method that imparts knowledge, enhances intrinsic motivation, promotes self learning, encourages clinical reasoning, and develops long-lasting memory. The aim of this study was to develop POPS in teaching pathology, assess its effectiveness, and assess students’ preference for POPS over didactic lectures.Method: One hundred fifty second-year MBBS students were divided into two groups: A and B. Group A was taught by POPS while group B was taught by traditional lectures. Pre- and post-test numerical scores of both groups were evaluated and compared. Students then completed a self-structured feedback questionnaire for analysis.Results: The mean (SD difference in pre- and post-test scores of groups A and B was 15.98 (3.18 and 7.79 (2.52, respectively. The significance of the difference between scores of group A and group B teaching methods was 16.62 (P < 0.0001, as determined by the z-test. Improvement in post-test performance of group A was significantly greater than of group B, demonstrating the effectiveness of POPS. Students responded that POPS facilitates self-learning, helps in understanding topics, creates interest, and is a scientific approach to teaching. Feedback response on POPS was strong in 57.52% of students, moderate in 35.67%, and negative in only 6.81%, showing that 93.19% students favored POPS over simple lectures.Conclusion: It is not feasible to enforce the PBL method of teaching throughout the entire curriculum; However, POPS can be incorporated along with audiovisual aids to break the monotony of dialectic lectures and as alternative to PBL.Keywords: medical education, problem-solving exercise, problem-based learning

The Actual (Un)usefulness of the Bologna System in Medical Education.

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Masic, Izet; Begic, Edin

2016-04-01

Faculty of Medicine, University of Sarajevo has officially started working on 22.11.1944, and is the oldest faculty in the medical field in Bosnia and Herzegovina. At the same time there are two systems of organization of the teaching process, the old system and the Bologna system. To analyze the implementation of the Bologna system, and making an overview of its justification. Answers from questionnaires from total of 459 students were analyzed (197 who had studied under the old system and 262 who studied under the Bologna system), so total of four generations of the Bologna system. They filled out a questionnaire in which they evaluated the teaching process. Student's opinion about quality of medical education was measured by modified Lickert scale. Students of old system are older than students of the Bologna process, whose average age is increasing from generation to generation, given the growing number of students who repeat a year. All students of old system repeated an academic year once or several times (p educational process (teachers, methods, effects). The only significant progress has been proven in terms of rating the degree of computerization of the educational process-general records on enrolled students (old system vs Bologna system-3,44 vs 3,63), record of attendance (3,47 vs 3,73), obtaining certificates (3,08 vs 3,84), method of registration of exam (2,98 vs 3,71), method of practical exam (3,06 vs 3,36) and theoretical methods of taking exam (3,01 vs 3,14). Average grades where no average grade, on any issue, does not reach grade 4 of Likert Scale, talks about real problems of education in medical field. In a relatively large sample (four generations of students) true benefit and progress of the Bologna system has not been proven, in comparison to the old system. Bologna system has eased the students in the administrative sense by introduction of computerization of faculties, but the old problems and old questions about the organization

Progress in Medical Radiation Physics

International Nuclear Information System (INIS)

Orton, C.G.

1982-01-01

In-depth reviews of the advances and concepts in the application of radiation to medicine are presented in six comprehensive review articles which help to bridge the communications gap between the international research community and the medical physicists and physicians whose responsibility it is to put these advances into clinical use. Topics include techniques used both for the diagnosis of disease, such as computerized tomography, digital radiography, ultrasonography, computerized nuclear medicine scanning, and nuclear magnetic resonance imaging, and for its treatment, such as the radiotherapeutic utilization of high-LET radiations, and the widespread application of computers to perform dosimetry calculations from 3-D treatment planning and imaging. Each chapter has extensive references and the collection is indexed

An interactive problem-solving approach to teach traumatology for medical students.

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Abu-Zidan, Fikri M; Elzubeir, Margaret A

2010-08-13

We aimed to evaluate an interactive problem-solving approach for teaching traumatology from perspectives of students and consider its implications on Faculty development. A two hour problem-solving, interactive tutorial on traumatology was structured to cover main topics in trauma management. The tutorial was based on real cases covering specific topics and objectives. Seven tutorials (5-9 students in each) were given by the same tutor with the same format for fourth and fifth year medical students in Auckland and UAE Universities (n = 50). A 16 item questionnaire, on a 7 point Likert-type scale, focusing on educational tools, tutor-based skills, and student-centered skills were answered by the students followed by open ended comments. The tutorials were highly ranked by the students. The mean values of educational tools was the highest followed by tutor-centered skills and finally student-centered skills. There was a significant increase of the rating of studied attributes over time (F = 3.9, p = 0.004, ANOVA). Students' open ended comments were highly supportive of the interactive problem-solving approach for teaching traumatology. The interactive problem-solving approach for tutorials can be an effective enjoyable alternative or supplement to traditional instruction for teaching traumatology to medical students. Training for this approach should be encouraged for Faculty development.

Application of object modeling technique to medical image retrieval system

International Nuclear Information System (INIS)

Teshima, Fumiaki; Abe, Takeshi

1993-01-01

This report describes the results of discussions on the object-oriented analysis methodology, which is one of the object-oriented paradigms. In particular, we considered application of the object modeling technique (OMT) to the analysis of a medical image retrieval system. The object-oriented methodology places emphasis on the construction of an abstract model from real-world entities. The effectiveness of and future improvements to OMT are discussed from the standpoint of the system's expandability. These discussions have elucidated that the methodology is sufficiently well-organized and practical to be applied to commercial products, provided that it is applied to the appropriate problem domain. (author)

45 CFR 307.25 - Review and certification of computerized support enforcement systems.

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2010-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES COMPUTERIZED SUPPORT ENFORCEMENT SYSTEMS § 307.25 Review and certification of computerized support enforcement systems. The Office will review, assess and inspect the... 45 Public Welfare 2 2010-10-01 2010-10-01 false Review and certification of computerized support...

Analysis of risk in computerized tomography and other diagnostic radiology procedures

International Nuclear Information System (INIS)

Mossman, K.L.

1982-01-01

Medical practice entails continuous risks to the patient taken in good faith by the physician for the benefit of the patient. Risk of radiation induced cancer death approximates 10(-4) per cGy (rad). Assuming an average whole body dose of 0.1 cGy for many diagnostic X-ray procedures, the probability of radiation-induced cancer death is about 10(-5). The purpose of this paper is to compare the risks of common diagnostic X-ray procedures including computerized tomography (CT) with risks of smoking or automobile travel. Such comparisons should be constructive in putting radiation in perspective and facilitating explanation of risk/benefit to patients

Development of BWR computerized operator support system for emergency conditions

International Nuclear Information System (INIS)

Murata, F.

1984-01-01

A BWR computerized operator support system (COSS) for emergency conditions has been under development for three years. The conceptual design of the system has been settled and some of the subsystems are in the detailed design or manufacturing stage. The principal functions are technical specification monitoring, diagnosis, guidance during emergency conditions, predictive simulation and safety monitoring. Before a reactor trip, alternative operational guidance for anomalous events is provided by utilization of the CTT (cause consequence tree) and FPS (failure propagation simulator). After the trip, operational guidance is based on event-oriented and symptom-oriented methods in association with the safety function monitor. The technical specification monitor controls the readiness monitor and performs surveillance tests of safety systems to maintain plant operational reliability and to ensure correct performance when initiated. The predictive simulator gives the future trends of significant plant parameters. These subsystems are expected to assist the operational personnel. The feasibility of the COSS functions is confirmed separately by off-line simulation. The paper considers the conceptual design, the functions of the subsystems and the off-line simulation results. Each subsystem has shown that useful information to operational personnel is provided. Henceforth these functions will be integrated into a single system and the feasibility will be thoroughly evaluated using a plant simulator which is being separately developed to verify the COSS. (author)

The agency problem and medical acting: an example of applying economic theory to medical ethics.

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Langer, Andreas; Schröder-Bäck, Peter; Brink, Alexander; Eurich, Johannes

2009-03-01

In this article, the authors attempt to build a bridge between economic theory and medical ethics to offer a new perspective to tackle ethical challenges in the physician-patient encounter. They apply elements of new institutional economics to the ethically relevant dimensions of the physician-patient relationship in a descriptive heuristic sense. The principal-agent theory can be used to analytically grasp existing action problems in the physician-patient relationship and as a basis for shaping recommendations at the institutional level. Furthermore, the patients' increased self-determination and modern opportunities for the medical laity to inform themselves lead to a less asymmetrical distribution of information between physician and patient and therefore require new interaction models. Based on the analysis presented here, the authors recommend that, apart from the physician's necessary individual ethics, greater consideration should be given to approaches of institutional ethics and hence to incentive systems within medical ethics.

Sexual Orientation and College Students' Reasons for Nonmedical Use of Prescription Drugs.

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Dagirmanjian, Faedra R; McDaniel, Anne E; Shadick, Richard

2017-07-03

Nonmedical use of prescription pain medications, sedatives, and stimulants is a well-documented problem among college students. Research has indicated that students who identify as lesbian, gay, or bisexual are at elevated risk. However, little is known about students' reasons for use. (1) To replicate findings that sexual minority students report higher nonmedical use than heterosexual students, moving from a campus-specific to a multicampus sample and (2) to test for an association between sexual orientation and reasons for use. The 2015 College Prescription Drug Study surveyed 3389 students from nine 4-year public and private colleges and universities across the United States using an anonymous online survey. Measures assessed demographic information, prevalence of nonmedical use, frequency of use, where the drugs were obtained, reasons for use, and consequences of use. Stepwise logistic regression models were used to determine if sexual orientation predicted use. Chi-square tests of independence were also used to analyze prevalence of use by demographics as well as to assess differences in reasons for use by sexual orientation. Sexual minority students were significantly more likely than heterosexual students to nonmedically use any prescription drug, pain medications, and sedatives. Sexual minority students were also more likely to select that they used pain medications to relieve anxiety, enhance social interactions, and to feel better. Conclusions/Importance: Although sexual minority students are more likely to report nonmedical use, students overall use prescription medications for similar reasons, with the exception of painkillers. Implications and areas for future research are discussed.

Prevalence of drug-related problems in self-medication in Danish community pharmacies

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Bente Frøkjær

2012-01-01

Full Text Available Background: Drug-related problems are known to be a major problem associated with pharmacotherapy. A broad range of studies, mainly in the area of prescription-only medicines, supports this fact. Only a few studies have evaluated drug-related problems with over-the-counter medicine and the role of community pharmacies in this. Purpose: To quantify drug-related problems in self-medication (use of over-the-counter medicine identified by community pharmacies in Denmark and to document the interventions by pharmacy staff in relation to the identified drug-related problems. Method: A descriptive study mapping drug-related problems in self-medication registered at the counter at a selected number of Danish community pharmacies. Results: Data for 3,868 consecutive customers with requests for over-the-counter (OTC medicines were registered at 39 community pharmacies. The pharmacies registered a total number of 4,324 OTC medicines requests, illustrating that a customer requested 1.1 OTC medicines on average. Drug-related problems (DRPs were identified for 813 customers, equivalent to DRPs for 21.0 % of all customers, presenting symptoms or requesting OTC medicines, and for 20 % of all over-the-counter medicines requests. 1,239 DRPs were registered, corresponding to an average of 1.5 DRPs per customer requesting OTC medicines. Community pharmacies estimated that they solved or partly solved 76.2 % of the detected DRPs; 73 % were solved without involving a general practitioner. Conclusions: DRPs were identified for 21.0 % of the pharmacy customers presenting a symptom or asking for an OTC medicine. The community pharmacy counselled the customers with DRPs more thoroughly than other customers by giving 2.4 pieces of professional advice, compared to an average of 2.1 to customers in general. It is not possible to determine the magnitude of the safety risk involved. Based on the most frequent categories of DRPs, there were risks of insufficient effect

Prevalence of drug-related problems in self-medication in Danish community pharmacies

Directory of Open Access Journals (Sweden)

Charlotte Rossing

2012-01-01

Full Text Available Background: Drug-related problems are known to be a major problem associated with pharmacotherapy. A broad range of studies, mainly in the area of prescription-only medicines, supports this fact. Only a few studies have evaluated drug-related problems with over-the-counter medicine and the role of community pharmacies in this.Purpose: To quantify drug-related problems in self-medication (use of over-the-counter medicine identified by community pharmacies in Denmark and to document the interventions by pharmacy staff in relation to the identified drug-related problems.Method: A descriptive study mapping drug-related problems in self-medication registered at the counter at a selected number of Danish community pharmacies.Results: Data for 3,868 consecutive customers with requests for over-the-counter (OTC medicines were registered at 39 community pharmacies. The pharmacies registered a total number of 4,324 OTC medicines requests, illustrating that a customer requested 1.1 OTC medicines on average. Drug-related problems (DRPs were identified for 813 customers, equivalent to DRPs for 21.0 % of all customers, presenting symptoms or requesting OTC medicines, and for 20 % of all over-the-counter medicines requests. 1,239 DRPs were registered, corresponding to an average of 1.5 DRPs per customer requesting OTC medicines.Community pharmacies estimated that they solved or partly solved 76.2 % of the detected DRPs; 73 % were solved without involving a general practitioner.Conclusions: DRPs were identified for 21.0 % of the pharmacy customers presenting a symptom or asking for an OTC medicine. The community pharmacy counselled the customers with DRPs more thoroughly than other customers by giving 2.4 pieces of professional advice, compared to an average of 2.1 to customers in general. It is not possible to determine the magnitude of the safety risk involved. Based on the most frequent categories of DRPs, there were risks of insufficient effect, unintended

[Medicine and orientalism in the late nineteenth century Korea].

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Lee, Jong-Chan

2002-06-01

The paper investigates medical missionaries that exerted a significant role in establishing Western medicine in the late nineteenth century Chosun, in relation to orientalism, an academically popularized concept introduced by Edward Said. Historical analysis is focused on several important medical missionaries such as Horace N. Allen, William B. Scranton, John W. Heron, C. C. Vinton, and Oliver R. Avison to explain how their activism as medical missionary contributed to the formation of medical orientalism in which Western medicine was 'taught, studied, administered, and judged' in that period. In addition, I explore into how medical orientalism was in service of Japanese imperialism by showing that medical missionaries had to be under imperial surveillance by Japanese colonizers. The article explores the medical system of the Koryo Dynasty period and its social characteristics. First, the structure of medical system and roles of medical institutions during the Koryo Dynasty period will be summarized. Then the characteristics of the medical system will be identified through exploring the principles of its formation in a view of social recognition of medical care and a view of social recognition of medical care and a view of public policy.

The evolution of the market for commercial computerized physician order entry and computerized decision support systems for prescribing.

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Mozaffar, Hajar; Williams, Robin; Cresswell, Kathrin; Morrison, Zoe; Bates, David W; Sheikh, Aziz

2016-03-01

To understand the evolving market of commercial off-the-shelf Computerized Physician Order Entry (CPOE) and Computerized Decision Support (CDS) applications and its effects on their uptake and implementation in English hospitals. Although CPOE and CDS vendors have been quick to enter the English market, uptake has been slow and uneven. To investigate this, the authors undertook qualitative ethnography of vendors and adopters of hospital CPOE/CDS systems in England. The authors collected data from semi-structured interviews with 11 individuals from 4 vendors, including the 2 most entrenched suppliers, and 6 adopter hospitals, and 21 h of ethnographic observation of 2 user groups, and 1 vendor event. The research and analysis was informed by insights from studies of the evolution of technology fields and the emergence of generic COTS enterprise solutions. Four key themes emerged: (1) adoption of systems that had been developed outside of England, (2) vendors' configuration and customization strategies, (3) localized adopter practices vs generic systems, and (4) unrealistic adopter demands. Evidence for our over-arching finding concerning the current immaturity of the market was derived from vendors' strategies, adopters' reactions to the technology, and policy makers' incomplete insights. The CPOE/CDS market in England is still in an emergent phase. The rapid entrance of diverse products, triggered by federal policy initiatives, has resulted in premature adoption of systems that do not yet adequately meet the needs of hospitals. Vendors and adopters lacked understanding of how to design and implement generic solutions to meet diverse user needs. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Prevalence and correlates of sleep-related problems in adults receiving medical cannabis for chronic pain.

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Cranford, James A; Arnedt, J Todd; Conroy, Deirdre A; Bohnert, Kipling M; Bourque, Carrie; Blow, Frederic C; Ilgen, Mark

2017-11-01

To examine the prevalence and correlates of sleep problems in a sample of medical cannabis patients. Adults ages 21 and older (N=801,M age=45.8) who were seeking medical cannabis certification (either for the first time or as a renewal) for chronic pain at medical cannabis clinics in southern Michigan completed baseline measures of cannabis use, sleep, pain, and other related constructs. Over half of the sample (59%) met criteria for past 1-month sleep disturbance, defined as at least one sleep problem occurring on 15 or more nights in the past month. Most participants (86%) reported that sleep problems were due to their current pain. Approximately 80% of participants reported using cannabis in the past 6 months to improve sleep and, among these participants, cannabis was rated as helpful for improving sleep. Sleep-related cannabis side effects were rare (35%), but sleep-related cannabis withdrawal symptoms were relatively common (65%). Statistically significant correlates of past 1-month sleep disturbance included a) being female, b) being white, c) being on disability, d) not having a medical cannabis card, and e) frequency of using cannabis to help sleep. Sleep problems are highly prevalent and frequent in medical cannabis patients and are closely tied to pain. Sleep-related cannabis withdrawal symptoms are relatively common but their clinical relevance is unknown. The association between frequency of cannabis use to help sleep with higher odds of sleep problems will need to be clarified by longitudinal studies. Copyright © 2017 Elsevier B.V. All rights reserved.

Computerized provider order entry in the clinical laboratory

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Baron, Jason M.; Dighe, Anand S.

2011-01-01

Clinicians have traditionally ordered laboratory tests using paper-based orders and requisitions. However, paper orders are becoming increasingly incompatible with the complexities, challenges, and resource constraints of our modern healthcare systems and are being replaced by electronic order entry systems. Electronic systems that allow direct provider input of diagnostic testing or medication orders into a computer system are known as Computerized Provider Order Entry (CPOE) systems. Adoption of laboratory CPOE systems may offer institutions many benefits, including reduced test turnaround time, improved test utilization, and better adherence to practice guidelines. In this review, we outline the functionality of various CPOE implementations, review the reported benefits, and discuss strategies for using CPOE to improve the test ordering process. Further, we discuss barriers to the implementation of CPOE systems that have prevented their more widespread adoption. PMID:21886891

Computerized provider order entry in the clinical laboratory

Directory of Open Access Journals (Sweden)

Jason M Baron

2011-01-01

Full Text Available Clinicians have traditionally ordered laboratory tests using paper-based orders and requisitions. However, paper orders are becoming increasingly incompatible with the complexities, challenges, and resource constraints of our modern healthcare systems and are being replaced by electronic order entry systems. Electronic systems that allow direct provider input of diagnostic testing or medication orders into a computer system are known as Computerized Provider Order Entry (CPOE systems. Adoption of laboratory CPOE systems may offer institutions many benefits, including reduced test turnaround time, improved test utilization, and better adherence to practice guidelines. In this review, we outline the functionality of various CPOE implementations, review the reported benefits, and discuss strategies for using CPOE to improve the test ordering process. Further, we discuss barriers to the implementation of CPOE systems that have prevented their more widespread adoption.

Computerized dosimetric system for studying radiation fields of afterloading apparatus

International Nuclear Information System (INIS)

Andryushin, O.S.; Gorshkov, M.I.

1988-01-01

Works on designing a computerized dosimetric scanner (CODOS) for studying radiation fields of remote therapeutic apparatus, providing dosimetric data input from semiconductor transducers and ionization chambers directly into the computer memory were carried out. The basic problems were to provide reproducibility and accuracy of the initial dosimetric data, formation of the data bank on LUEhV-15M1 accelerator bremsstrahlung and electron radiation fields. An extra problem was to provide isodose curves for manual scheduling of radiotherapy. The 15 VUMS-28-025 complex based on Elektronika-60 computer was chosen as a host computer, photodiodes were used as a semiconductor detector, the 70108 rod chamber and VA-J-18 dosemeters were used as an ionization chamber. The results of studies with the CODOS system have been shown that it meets the dosimetric requirements for therapeutic apparatus

Application of the STOPP/START criteria to a medical record database.

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Nauta, Katinka J; Groenhof, Feikje; Schuling, Jan; Hugtenburg, Jacqueline G; van Hout, Hein P J; Haaijer-Ruskamp, Flora M; Denig, Petra

2017-10-01

The STOPP/START criteria are increasingly used to assess prescribing quality in elderly patients at practice level. Our aim was to test computerized algorithms for applying these criteria to a medical record database. STOPP/START criteria-based computerized algorithms were defined using Anatomical-Therapeutic-Chemical (ATC) codes for medication and International Classification of Primary Care (ICPC) codes for diagnoses. The algorithms were applied to a Dutch primary care database, including patients aged ≥65 years using ≥5 chronic drugs. We tested for associations with patient characteristics that have previously shown a relationship with the original STOPP/START criteria, using multivariate logistic regression models. Included were 1187 patients with a median age of 75 years. In total, 39 of the 62 STOPP and 18 of the 26 START criteria could be converted to a computerized algorithm. The main reasons for inapplicability were lack of information on the severity of a condition and insufficient covering of ICPC-codes. We confirmed a positive association between the occurrence of both the STOPP and the START criteria and the number of chronic drugs (adjusted OR ranging from 1.37, 95% CI 1.04-1.82 to 3.19, 95% CI 2.33-4.36) as well as the patient's age (adjusted OR for STOPP 1.30, 95% CI 1.01-1.67; for START 1.73, 95% CI 1.35-2.21), and also between female gender and the occurrence of STOPP criteria (adjusted OR 1.41, 95% CI 1.09-1.82). Sixty-five percent of the STOPP/START criteria could be applied with computerized algorithms to a medical record database with ATC-coded medication and ICPC-coded diagnoses. Copyright © 2017 John Wiley & Sons, Ltd.

Sexual orientation and alcohol problem use among U.K. adolescents: an indirect link through depressed mood.

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Pesola, Francesca; Shelton, Katherine H; van den Bree, Marianne B M

2014-07-01

Sexual minority adolescents are more likely to engage in alcohol use than their heterosexual counterparts; however, the underlying reasons remain unclear and longitudinal research is limited. Owing to evidence that this group also experiences greater depressive symptoms than their peers, we aimed to (i) assess to what extent depressed mood explains the increased likelihood of engaging in alcohol use among sexual minority adolescents, and (ii) explore potential gender-specific patterns. Structural equation modelling was used to test the indirect relationship between sexual orientation and alcohol use through depressed mood, with heterosexuals as the reference group. A total of 3710 adolescents (12% sexual minority), from the Avon Longitudinal Study of Parents and Children (ALSPAC) study, assessed between the ages of 15 and 18 years. Sexual orientation was assessed at age 15, while alcohol use was measured using the Alcohol Use Disorders Identification Test (AUDIT) at age 18. Depressed mood was indexed by the Short Mood and Feelings Questionnaire (SMFQ) at age 16. Sexual minority adolescents were more likely to engage in alcohol problem use compared to their heterosexual counterparts [Btotal  = 0.12, 95% confidence interval (CI) = 0.04-0.20, P = 0.003]. Depressed mood explained 21% of the link between sexual orientation and alcohol use after adjustment for covariates and earlier measures (Z = 3.2, P = 0.001). No gender differences were observed. A higher prevalence of alcohol problem use in adolescents who are gay, lesbian or bisexual is partly explained by increased rates of depression in this group. © 2014 Society for the Study of Addiction.

Longitudinal retention of anatomical knowledge in second-year medical students.

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Doomernik, Denise E; van Goor, Harry; Kooloos, Jan G M; Ten Broek, Richard P

2017-06-01

The Radboud University Medical Center has a problem-based, learner-oriented, horizontally, and vertically integrated medical curriculum. Anatomists and clinicians have noticed students' decreasing anatomical knowledge and the disability to apply knowledge in diagnostic reasoning and problem solving. In a longitudinal cohort, the retention of anatomical knowledge gained during the first year of medical school among second-year medical students was assessed. In May 2011, 346 medical students applied for the second-year gastro-intestinal (GI) tract course. The students were asked to participate in a reexamination of a selection of anatomical questions of an examination from October 2009. The examination consisted of a clinical anatomy case scenario and two computed tomography (CT) images of thorax and abdomen in an extended matching format. A total of 165 students were included for analysis. In 2011, students scored significantly lower for the anatomy examination compared to 2009 with a decline in overall examination score of 14.7% (±11.7%). Decrease in knowledge was higher in the radiological questions, compared to the clinical anatomy cases 17.5% (±13.6%) vs. 7.9% (±10.0%), respectively, d = 5.17. In both years, male students scored slightly better compared to female students, and decline of knowledge seems somewhat lower in male students (13.1% (±11.1%) vs. 15.5% (±12.0%), respectively), d = -0.21. Anatomical knowledge in the problem-oriented horizontal and vertical integrated medical curriculum, declined by approximately 15% 1.5 year after the initial anatomy course. The loss of knowledge in the present study is relative small compared to previous studies. Anat Sci Educ 10: 242-248. © 2016 American Association of Anatomists. © 2016 American Association of Anatomists.

Energy functionals for medical image segmentation: choices and consequences

OpenAIRE

McIntosh, Christopher

2011-01-01

Medical imaging continues to permeate the practice of medicine, but automated yet accurate segmentation and labeling of anatomical structures continues to be a major obstacle to computerized medical image analysis. Though there exists numerous approaches for medical image segmentation, one in particular has gained increasing popularity: energy minimization-based techniques, and the large set of methods encompassed therein. With these techniques an energy function must be chosen, segmentations...

Medication safety programs in primary care: a scoping review.

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Khalil, Hanan; Shahid, Monica; Roughead, Libby

2017-10-01

measures. The objectives, inclusion criteria and methods for this scoping review were specified in advance and documented in a protocol that was previously published. This scoping review included nine studies published over an eight-year period that investigated or described the effects of medication safety programs in primary care settings. We classified each of the nine included studies into three main sections according to whether they included an organizational, professional or patient component. The organizational component is aimed at changing the structure of the organization to implement the intervention, the professional component is aimed at the healthcare professionals involved in implementing the interventions, and the patient component is aimed at counseling and education of the patient. All of the included studies had different types of medication safety programs. The programs ranged from complex interventions including pharmacists and teams of healthcare professionals to educational packages for patients and computerized system interventions. The outcome measures described in the included studies were medication error incidence, adverse events and number of drug-related problems. Multi-faceted medication safety programs are likely to vary in characteristics. They include educational training, quality improvement tools, informatics, patient education and feedback provision. The most likely outcome measure for these programs is the incidence of medication errors and reported adverse events or drug-related problems.

An analysis of medical students’ reflective essays in problem-based learning

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Jihyun Si

2018-03-01

Full Text Available Purpose This study aimed to explore students’ learning experience in problem-based learning (PBL particularly in terms of what they learned and how they learned in one Korean medical school by analyzing their reflective essays with qualitative research methods. Methods This study included 44 first-year medical students. They took three consecutive PBL courses and wrote reflective essays 3 times anonymously on the last day of each course. Their reflective essays were analyzed using an inductive content analysis method. Results The coding process yielded 16 sub-categories and these categories were grouped into six categories according to the distinctive characteristics of PBL learning experience: integrated knowledge base, clinical problem solving, collaboration, intrinsic motivation, self-directed learning, and professional attitude. Among these categories, integrated knowledge base (34.68% and professional attitude (2.31% were the categories mentioned most and least frequently. Conclusion The findings of this study provide an overall understanding of the learning experience of Korean medical students during PBL in terms of what they learned and how they learned with rich descriptive commentaries from their perspectives as well as several thoughtful insights to help develop instructional strategies to enhance the effectiveness of PBL.

The effects of problem-based learning during medical school on physician competency: a systematic review.

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Koh, Gerald Choon-Huat; Khoo, Hoon Eng; Wong, Mee Lian; Koh, David

2008-01-01

Systematic reviews on the effects of problem-based learning have been limited to knowledge competency either during medical school or postgraduate training. We conducted a systematic review of evidence of the effects that problem-based learning during medical school had on physician competencies after graduation. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Databases, and the tables of contents of 5 major medical education journals from earliest available date through Oct. 31, 2006. We included studies in our review if they met the following criteria: problem-based learning was a teaching method in medical school, physician competencies were assessed after graduation and a control group of graduates of traditional curricula was used. We developed a scoring system to assess the quality of the studies, categorized competencies into 8 thematic dimensions and used a second system to determine the level of evidence for each competency assessed. Our search yielded 102 articles, of which 15 met inclusion criteria after full text review. Only 13 studies entered final systematic analysis because 2 studies reported their findings in 2 articles. According to self-assessments, 8 of 37 competencies had strong evidence in support of problem-based learning. Observed assessments had 7 competencies with strong evidence. In both groups, most of these competencies were in the social and cognitive dimensions. Only 4 competencies had moderate to strong levels of evidence in support of problem-based learning for both self-and observed assessments: coping with uncertainty (strong), appreciation of legal and ethical aspects of health care (strong), communication skills (moderate and strong respectively) and self-directed continuing learning (moderate). Problem-based learning during medical school has positive effects on physician competency after graduation, mainly in social and cognitive dimensions.

Computerized photogrammetry used to calculate the brow position index.

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Naif-de-Andrade, Naif Thadeu; Hochman, Bernardo; Naif-de-Andrade, Camila Zirlis; Ferreira, Lydia Masako

2012-10-01

The orbital region is of vital importance to facial expression. Brow ptosis, besides having an impact on facial harmony, is a sign of aging. Various surgical techniques have been developed to increase the efficacy of brow-lift surgery. However, no consensus method exists for an objective measurement of the eyebrow position due to the curvature of the face. Therefore, this study aimed to establish a method for measuring the eyebrow position using computerized photogrammetry. For this study, 20 orbital regions of 10 volunteers were measured by direct anthropometry using a digital caliper and by indirect anthropometry (computerized photogrammetry) using standardized digital photographs. Lines, points, and distances were defined based on the position of the anthropometric landmarks endocanthion and exocanthion and then used to calculate the brow position index (BPI). Statistical analysis was performed using Student's t test with a significance level of 5 %. The BPI values obtained by computerized photogrammetric measurements did not differ significantly from those obtained by direct anthropometric measurements (p > 0.05). The mean BPI was 84.89 ± 10.30 for the computerized photogrammetric measurements and 85.27 ± 10.67 for the direct anthropometric measurements. The BPI defined in this study and obtained by computerized photogrammetry is a reproducible and efficient method for measuring the eyebrow position. This journal requires that authors assign a level of evidence to each article.

Computerized three-dimensional treatment planning system utilizing interactive colour graphics

Energy Technology Data Exchange (ETDEWEB)

McShan, D L; Silverman, A; Lanza, D M; Reinstein, L E; Glicksman, A S [Rhode Island Hospital (US). Dept. of Radiation Oncology

1979-06-01

A new computerized radiation treatment planning system has been developed to aid in three-dimensional treatment planning. Using interactive colour graphics in conjunction with a PDP 11/45 computer, the system can take multiple transverse contours and construct a perspective display of the treatment region showing organ surfaces as well as cross-sectional contours. With interactively selected orientations, the display allows easy perception of the relative positioning of the treatment volume and the neighbouring anatomy. For external beam treatment planning, interactive computer simulation is used to select diaphragm sizes which best conform to the target area while avoiding sensitive structures. Dose calculations for the selected beams are carried out on multiple transverse planes. The calculational planes and surfaces are displayed in perspective with radiation dosage displayed in an interactively manipulated colour display. Altogether the system provides an easy assessment of the volume to be irradiated, interactive selection of optimal arrangements of treatment fields and a means of visualizing and evaluating the resulting dose distributions.

Computerized versus hand-scored health literacy tools: a comparison of Simple Measure of Gobbledygook (SMOG) and Flesch-Kincaid in printed patient education materials.

Science.gov (United States)

Grabeel, Kelsey Leonard; Russomanno, Jennifer; Oelschlegel, Sandy; Tester, Emily; Heidel, Robert Eric

2018-01-01

The research compared and contrasted hand-scoring and computerized methods of evaluating the grade level of patient education materials that are distributed at an academic medical center in east Tennessee and sought to determine if these materials adhered to the American Medical Association's (AMA's) recommended reading level of sixth grade. Librarians at an academic medical center located in the heart of Appalachian Tennessee initiated the assessment of 150 of the most used printed patient education materials. Based on the Flesch-Kincaid (F-K) scoring rubric, 2 of the 150 documents were excluded from statistical comparisons due to the absence of text (images only). Researchers assessed the remaining 148 documents using the hand-scored Simple Measure of Gobbledygook (SMOG) method and the computerized F-K grade level method. For SMOG, 3 independent reviewers hand-scored each of the 150 documents. For F-K, documents were analyzed using Microsoft Word. Reading grade levels scores were entered into a database for statistical analysis. Inter-rater reliability was calculated using intra-class correlation coefficients (ICC). Paired t -tests were used to compare readability means. Acceptable inter-rater reliability was found for SMOG (ICC=0.95). For the 148 documents assessed, SMOG produced a significantly higher mean reading grade level (M=9.6, SD=1.3) than F-K (M=6.5, SD=1.3; p SMOG method of assessment, 147 of the 148 documents (99.3%) scored above the AMA's recommended reading level of sixth grade. Computerized health literacy assessment tools, used by many national patient education material providers, might not be representative of the actual reading grade levels of patient education materials. This is problematic in regions like Appalachia because materials may not be comprehensible to the area's low-literacy patients. Medical librarians have the potential to advance their role in patient education to better serve their patient populations.

Radiographic analysis of body composition by computerized axial tomography

International Nuclear Information System (INIS)

Heymsfield, S.B.

1986-01-01

Radiographic methods of evaluating body composition have been applied for over five decades. A marked improvement in this approach occurred in the mid-nineteen-seventies with the introduction of computerized axial tomography. High image contrast, cross-sectional imaging and rapid computerized data processing make this technique a sophisticated clinically applicable tool. (author)

Active teaching-learning methodologies: medical students' views of problem-based learning

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José Roberto Bittencourt Costa

Full Text Available The prevailing undergraduate medical training process still favors disconnection and professional distancing from social needs. The Brazilian Ministries of Education and Health, through the National Curriculum Guidelines, the Incentives Program for Changes in the Medical Curriculum (PROMED, and the National Program for Reorientation of Professional Training in Health (PRO-SAÚDE, promoted the stimulus for an effective connection between medical institutions and the Unified National Health System (SUS. In accordance to the new paradigm for medical training, the Centro Universitário Serra dos Órgãos (UNIFESO established a teaching plan in 2005 using active methodologies, specifically problem-based learning (PBL. Research was conducted through semi-structured interviews with third-year undergraduate students at the UNIFESO Medical School. The results were categorized as proposed by Bardin's thematic analysis, with the purpose of verifying the students' impressions of the new curriculum. Active methodologies proved to be well-accepted by students, who defined them as exciting and inclusive of theory and practice in medical education.