Biomedical subjects

P S Woolman

Publications and source records attributed to P S Woolman.

9 recordsLinked to original sources

PubMed2001

XML for electronic clinical communications in Scotland.

This paper describes the use of extensible markup language (XML) for electronic clinical communications in Scotland. It gives the results of the first UK project to send and receive discharge letters using XML. This pilot had the advantage of transferring readable clinical information between computer systems and giving the receiving GP choice of decoding and saving clinical and administrative data into his practice system. A number of existing clinical systems and a variety of written documents were studied. Existing trial standards, including the NHS EDIFACT, HL7v2 and CEN standard ENV 13606 were taken into consideration. The project worked with the receiving GP system supplier, GPASS, and the NHS Scotland Information and Statistics Division in defining the document type definition (DTD) for the pilot DTD. GPASS undertook production of a module for their system to parse the XML messages into the patient record on the GP system. The system allows the GP to read and print the original document and modify the content prior to storing in the practice system. SMTP e-mail messages were used for the pilot. Resulting messages were parsed into the GP system and validated by a variety of GP users. Currently there is a large scale program to develop XML Schema and web browser based communications of referrals, discharge and laboratory orders and reports.

Computer Communication Networks↗

PubMed2000

XML for immediate discharge letters in Scotland.

This paper describes the results of the first UK project to send and receive discharge letters using XML as a message format for clinical data. The SIGN guideline for immediate discharge has broad clinical acceptance across Scotland and forms the basis for the discharge message content. NHS net as a secure private network and X400 as a secure e-mail message format is intended for the final production systems. Internet mail was used for validating. The Scottish Immediate Discharge Project has the advantage of transferring readable clinical information between computer system and giving the receiving GP choice of decoding and saving clinical and administrative data into his practice system. The design of the Document Type Definition was built using the established standard for XML version 1.0. A number of existing discharge letter systems and a variety of written letters were studied. Existing trial standards, including the EDIFACT and CEN standards were taken into consideration. The project worked with the receiving GP system supplier, GPASS, and the NHSiS Information and Statistics Division in defining the DTD for the pilot. GPASS undertook production of a module for their system to parse the XML message into the patient record on the GP system. The system allows the GP to read and print the original document and modify the content prior to storing in the practice system. Care was taken to avoid sending real patient information for the pilot project. SMTP email messages were used rather than X400 because NHS net was not yet implemented at the pilot hospital sites. Resulting messages were parsed into the GP system and validated by a variety of GP users.

Computer Communication Networks↗

PubMed1998

A system for psychomotor evaluation; design, implementation and practice effects in volunteers.

This paper describes the design, implementation and assessment of PsychE, psychomotor evaluation system. Six standard tests are included: numeric vigilance, a dual task, probed memory recall, simple reaction time, choice reaction time and semantic long-term memory. The test presentations are described in detail. Practice effects were assessed in 10 healthy volunteers and were only evident in the performance measures for the simple reaction time test. For the remaining five tests, stable performance was reached within a single test session. The volunteers were healthy and most were regular users of computers. Therefore, the lack of practice effects cannot be assumed for the general population. A control group is essential for all studies using these tests. The system is implemented on an IBM-compatible personal computer and includes a database shell for the convenient collection, storage and analysis of performance data.

Adolescent↗

PubMed1995

Enoximone and warming after hypothermic cardiopulmonary bypass.

In a randomized, controlled study of 24 patients undergoing myocardial revascularization, we found that enoximone 0.5 mg kg-1 i.v., followed by 5 micrograms kg-1 min-1, when rewarming after hypothermic cardiopulmonary bypass, prevented subsequent cooling of the periphery after transfer to the intensive care unit. Skin surface temperatures on the foot increased by mean 0.33 (SD 0.5) degree C h-1 in the enoximone group, but decreased by 0.43 (0.4) degree C h-1 in the control group until core temperature had increased to 37 degrees C (P < 0.001); only then did peripheral temperatures begin to increase in the control group. Enoximone did not merely redistribute heat from the core to the periphery. The capacity to transfer heat by the circulation rather than the ability to generate heat in the core appeared to limit body warming in the ICU after hypothermic cardiopulmonary bypass.

Adult↗

PubMed1994

Convective warming after hypothermic cardiopulmonary bypass.

In a randomized, controlled study, we found that convective warming after hypothermic cardiopulmonary bypass did not accelerate the rate of warming of the body core or the time to tracheal extubation. The relationship between body core and shell temperature, however, was affected. In all patients inadequate time spent rewarming on cardiopulmonary bypass prolonged body core warming time and time to tracheal extubation. Rate of warming of body core was inversely related to body mass index. Convective warming was delivered using BairHugger (Augustine Medical Inc., MN, USA) and Warm Touch (Mallinckrodt Medical UK Ltd, Northampton, UK) blankets. There was no difference between the performance of each blanket when powered by the BairHugger 500 power unit set at its medium setting of 38 degrees C, and when chest drain and radial artery cannulation sites were left exposed for observation.

Aged↗

PubMed1992

A universal data acquisition program for use with anesthetic monitors and Windows 3.0.

A method is described whereby a single program can acquire data from any patient monitor which has a data output facility. No changes are necessary to the program for different monitors. It provides a method of standardizing data transfer between computers and monitors. The program runs in the Microsoft Windows 3.0 operating system. It utilizes Dynamic Link Libraries (DLL) which enable the operating system to communicate with monitors. Each kind of monitor will use a unique DLL in order to provide a standard interface to the Windows 3.0 operating system.

Anesthesiology↗

PubMed1989

Sites of deposition of aqueous aerosols: a study of efficiency of delivery systems for lung ventilation imaging in man.

A study was made of the deposition of 99Tcm-DTPA aerosol in the components of a jet nebulizer-based aerosol production system. Three impaction devices were compared: a ball-bearing separator, a virtual impactor and a step separator. In addition a comparison was made of two types of tubing which carried aerosol from nebulizer to mouthpiece: corrugated and smooth-walled tubing. The retention of aerosol following inhalation was measured in five normal volunteers using different patterns of breathing. Using an aerosol production system which included a ball-bearing separator only a mean of 11% of the radioactivity loaded into the nebulizer was emitted as an aerosol. Some 18% remained in the ball-bearing separator. The ball-bearing and step separators produced similar total outputs (7% and 6% minimum), the step separator producing marginally higher mean output/min. The virtual impactor produced a lower output than the other two impactors studied, only 1%. A larger proportion of the aerosol output was deposited on corrugated tubing (7%) compared with smooth-walled tubing (1%). The retained fraction of the aerosol inhaled by subjects ranged from 16% to 43%. A higher fraction was retained when subjects inhaled deeply and held their breath for 10 s between each breath. The efficiency of radionuclide deposition from aerosol generator to patient ranged from 1.1% to 6% and was determined more by the retention in the subject than by choice of separator or tubing.

Aerosols↗

PubMed1988

Accurate measurement of airway thermal challenge.

Rapid and accurate measurement of air temperature is needed to determine both heat and water losses from the respiratory tract during breathing. We have designed, constructed and validated a low dead-space, two-channel valve/mouthpiece which prevents mixing of inspired and expired air outside the body. The effects of airflow on the thermocouple response time and of thermocouple position within the airstream on the temperature measured were assessed. The 63% thermocouple response time fell from 159 to 78.8 ms as airflow rose from 23.7 to 297 1 min-1, a range including the peak flows observed while breathing at rest and during exercise. Measurement of temperature profiles across the valve/mouthpiece at different flows indicated that thermocouples were best positioned at the centre of the airstream, though small deviations did not adversely affect accuracy.

Body Temperature Regulation↗

PubMed1987

The rapid reversibility of effects of changing lung volume on the clearance rate of inhaled 99Tcm-DTPA in man.

Five normal non-smoking subjects inhaled an aerosol of 99Tcm-DTPA in saline with a mass median aerodynamic diameter of 0.6 micron. The rate of clearance (k) of the inhaled 99Tcm-DTPA from lung to blood was measured using a gamma scintillation camera with computer data acquisition. During a single clearance study the subjects voluntarily breathed close to total lung capacity (TLC) and close to residual volume (RV). They breathed at one volume for 5 min, then at the opposite volume for 5 min and finally reverted to the original volume for 5 min with a 1 min pause between each manoeuvre. The order in which each subject performed these breathing patterns was randomized. Tidal volume, respiratory frequency and end expired volume were measured with a water spirometer. When they breathed close to TLC the rate of clearance increased (k = 4.62 +/- 1.03%/min) compared with breathing close to RV (k = 1.96 +/- 0.5%/min). This effect of changing volume was immediately reversible after adopting each new lung volume. There were no significant changes in tidal volume or respiratory frequency between each 5 min period. There was no significant difference between the clearance increased (k = 4.62 +/- 1.03%/min) compared with breathing close to RV (k = 1.96 +/- 0.5%/min). This effect of changing volume was immediately reversible after adopting immediate and reversible.

Administration, Inhalation↗