Some systems implications of EU data protection directive.
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Computer Security↗
Biomedical subjects
B Barber
Publications and source records attributed to B Barber.
Effect of a dynein inhibitor on vasopressin action in toad urinary bladder.
1. The effect of the dynein inhibitor erythro-9-[3-(2-hydroxynonyl)] adenine (EHNA) on the osmotic water flow response to vasopressin or exogenous cAMP has been investigated in isolated toad urinary bladders. 2. Pretreatment with serosal EHNA had no effect on basal water flow, but inhibited the development and maintenance of the hydrosmotic response to vasopressin (20 mU ml-1) or 8-(4-parachlorophenylthio)-adenosine 3',5'-cyclic monophosphate (8 CPT-cAMP; 0.1 mM). 3. The inhibitory effect of EHNA on vasopressin-induced water flow was dose dependent. Inhibition occurred in the dose range in which EHNA inhibits the ATPase and motor activities of dynein in vitro. 4. EHNA also inhibited the maintenance of the high rate of water flow established by prior exposure to vasopressin. 5. The inhibitory effect of EHNA on the onset phase of the vasopressin response was attenuated after exposure of the tissue to the microtubule-disruptive drug nocodazole but was fully additive with that of cytochalasin B. 6. EHNA inhibited basal and vasopressin-stimulated transepithelial sodium transport. 7. The findings support the view that EHNA inhibits hormone-induced water flow through an action on a cytoplasmic dynein. The results are consistent with the hypothesis that dynein is involved in the microtubule-based delivery of water channel-containing vesicles to the apical membrane of the granular epithelial cells during both the onset and maintenance of the water permeability response to vasopressin.
Adenine↗
Evaluating health-related quality of life in patients with facial acne: development of a self-administered questionnaire for clinical trials.
Although psychosocial aspects of skin diseases are well known, disease-specific questionnaires validated for use in clinical trials are not available to assess the impact of facial acne on health-related quality of life or to evaluate therapeutic change. Development of such an instrument was undertaken and included item generation, reduction and pilot-testing phases. By interviewing acne subjects and dermatologists and literature review, 168 possible items were identified. Next, 165 acne subjects identified which items affected them and rated importance on a 5-point scale. Reduction to a brief questionnaire was performed by evaluating patient-perceived importance and factor analysis; four domains were identified (self-perception, role-emotional, role-social, acne symptoms). After pilot-testing for comprehension in acne subjects, further revisions were made to improve clarity and applicability. The resulting instrument takes 10 minutes to complete, and consists of 24 questions assessing how acne affected certain aspects of patients' lives during the past week on a 7-point scale. Thus, an instrument with excellent content validity was developed to assess health-related quality of life in patients with facial acne, and is comprised of statistically meaningful items of importance to patients. Other measurement characteristics are being assessed in a recently initiated study to evaluate test-retest reliability and responsiveness to therapy.
Acne Vulgaris↗
Overall observations, conclusions and recommendations.
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Computer Communication Networks↗
Risk analysis in health care establishments.
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Computer Security↗
Security in hospital information systems.
The paper links the previous and proposed activities of IMIA WG4 with the developments of IMIA WG10. The fading systems boundaries, increasing and integrated functionality together with the increasing use of information within HIS to care for patients raises the questions of whether HIS should be treated as 'safety critical' systems or medical devices and tested appropriately. These considerations immediately lead to the need to establish appropriate security standards for HIS.
Computer Communication Networks↗
A brief male sexual function inventory for urology.
OBJECTIVES: To develop a brief questionnaire to measure male sexual function. METHODS: An initial set of questions was refined and reduced through cognitive testing and two serial validation studies. In each study, men were recruited from a sexual dysfunction clinic and a general medicine practice to complete the instrument. Test-retest reliabilities, internal consistencies, and construct validities were examined. RESULTS: The final instrument covers sexual drive (two items), erection (three items), ejaculation (two items), perceptions of problems in each area (three items), and overall satisfaction (one item). Psychometric performance was generally very satisfactory, although self-assessments of ejaculate volume are problematic. Translations have been developed and pilot tested in a number of languages. CONCLUSIONS: The Brief Sexual Function Inventory may be useful for measuring male sexual function in practice and research.
Coitus↗
How to achieve secure environments for information systems in medicine.
The efficiency of modern health care relies more and more upon a computerized infrastructure. Open distributed IT-systems have started to bring professionals together from all around the world. Multimedia applications integrate formerly separated functionalities. On the one hand, easy processing and communication of images, sounds, and texts will help to represent illnesses and diseases holistically. But, on the other hand, such technology may compromise the privacy of patients, and may subvert the accountability and professional secrecy of health care professionals. The European Union has initiated a multi-disciplinary project to come up with practical guidelines on how to achieve a Secure Environment for Information Systems in MEDicine (SEISMED). It has taken into account the traditional and proven principles of health care data processing, the various legislations within the EU, the enormous and subtle risks of health care IT-systems, and the cost of changing existing technology.
Computer Communication Networks↗
Approaching safe and secure health information systems in Europe.
Information systems in health care are being utilised in more and more demanding and more clinical situations where security and safety issues become more significant. These issues are explored within the context of the UK National Health Service and the corresponding activities within the European Union.
Computer Security↗
A methodology for evaluation of knowledge-based systems in medicine.
Evaluation is critical to the development and successful integration of knowledge-based systems into their application environment. This is of particular importance in the medical domain--not only for reasons of safety and correctness, but also to reinforce the users' confidence in these systems. In this paper we describe an iterative, four-phased development evaluation cycle covering the following areas: (i) early prototype development, (ii) validity of the system, (iii) functionality of the system, and (iv) impact of the system.
Artificial Intelligence↗
An initial approach to the security techniques required by the electronic patient record.
Security aspects applicable to the paperless Electronic Paper Record are explored. It is believed that digital signatures will provide assurance of the authentication and the integrity of the components of the record in transmission but there are significant problems in respect of the long-term storage of the records.
Computer Communication Networks↗
Computing. Guardians or gizmos.
Carefully planned security management strategies are as important as the latest gadgets for ensuring patient details stay confidential, says Barry Barber, while Bill Goodwin examines the case for a risk analysis and management package.
Computer Security↗
Hospital comparisons using a Euro Health Data Base for resource management and strategic planning.
A European approach for resource management and strategic planning has been implemented in the HOSCOM project of AIM by defining information standards needed across countries, as well as a methodology to measure resources and costs at the institutional and interinstitutional level. A Euro Health Data Base (EHDB) has been obtained in order to test data availability and comparability as well as to validate models through macrocomparisons using case-mix (DRG's, refined grouping, disease staging) and microcomparisons based on three diseases (cardiac valve replacement, diabetes mellitus and hip fracture). The EHDB's presently based on 274 164 medical record summaries sampled from 7 countries allowed us to build prototypes (using Clipper, Prolog and SQL) in order to export uniform aggregates in the different countries, with standard software tools for statistical comparisons. It showed the present feasibility of using case-mix based on the European Minimum Basic Data Set (MBDS) and the difficulty of obtaining uniform data on resources and costs other than length of stay across countries. Medical data confidentiality was assured but not yet population-based representativity. Given the present state of the EHDB, problems have been clearly identified in order to be solved by international research and development projects in the near future.
Abstracting and Indexing↗
The six safety first principles of health information systems: a programme of implementation. Part 1. Safety and security.
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Computer Security↗
The six safety first principles of health information systems: a programme of implementation. Part 2. The environment, convenience and legal issues.
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Computer Security↗
The six safety first principles of health information systems. Progress report.
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Computer Security↗
Assembly of MHC class I molecules analyzed in vitro.
Recent evidence suggests that peptide ligands take part in the assembly of class I molecules in living cells. We now describe a simple system for studying class I assembly in vitro. Detergent extracts of the mutant cells RMA-S and .174, in which class I assembly does not occur spontaneously, will support assembly in vitro when specific peptides are added. Peptides stabilize a conformational change in the class I heavy chain and association with beta 2-microglobulin, at concentrations approximately 100-fold lower than required in "peptide feeding" experiments with whole cells. We show that peptides bind class I molecules during assembly and demonstrate that the conformational change induced in the heavy chain is influenced by the concentrations of both peptide and beta 2-microglobulin.
Amino Acid Sequence↗
Genetic aspects of ion transport systems in hypertension.
Environmental factors, genetic polymorphism and differences in experimental design have been the main impediments to evaluating the evidence for a genetic association between cell membrane cation transport abnormalities and human essential or genetic hypertension. The present paper reviews the results obtained in the Milan hypertensive rat (MHS) and in its corresponding normotensive strain (MNS) in order to illustrate our approach to defining the role of cation transport abnormality in a particular type of genetic hypertension. Kidney cross-transplantation between the strains showed that hypertension is transplanted along with the kidney. Proximal tubular cell volume and sodium content were lower in MHS rats while sodium transport across the brush border membrane vesicles of MHS rats was faster. Erythrocytes of MHS rats have a smaller volume, faster Na,K cotransport and a lower Km for internal sodium compared with MNS rats. The faster cotransport is also present in renal cells of the ascending limb and in vascular muscle cells. Moreover, these erythrocyte abnormalities are genetically associated in F2 hybrids and are primarily determined in the stem cells. These differences in ion transport between MHS and MNS rats are not present when studied in erythrocyte inside-out vesicles, which are deprived of membrane skeletal proteins, suggesting that a molecular abnormality underlies the functional one. We have identified a point mutation of one of these cytoskeletal membrane protein adducin genes in MHS rats. At present we are evaluating the possibility that mutation of the adducin gene in MHS rats might account for the differences in ion transport and, therefore, in blood pressure between the two strains.
Animals↗