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At least 433 records · Page 24Linked to original sources
PubMed1995

An analysis of the paper-based health record: information content and its implications for electronic patient records.

An analysis of paper-based charting was carried out at Sunnybrook Health Sciences Center as a prelude to developing a strategic plan to implement an electronic patient record. A relational model of the Sunnybrook paper chart was developed, describing each of its forms in terms of specific data fields. Three hundred and forty nine different forms are in current use at Sunnybrook, containing 64 types of data fields such as Patient Demographics, Vital Signs, and Doctor's Orders. The extent of data field duplication at the level of hospital forms was significant. A Patient Demographics field was present on all forms and on all pages of a patient's chart, as would be expected. Twenty seven other fields were duplicated on more than ten different forms, including Working Diagnosis which was present on 110 forms, History of Past Illness on 42 forms, and History of Present Illness on 32 forms. Current Medications were recorded on 32 forms and Allergy fields were present on 29 separate forms. Only five data fields of the total 64 were present on only one form. The duplication of data fields within complete patient charts was then examined to confirm that data field duplication was occurring within the actual healthcare delivery process. Using the relational model of the charting system, 143 acute care in-patient encounters were abstracted into the database. The charts were selected randomly from each of the hospital inpatient services. The numbers and types of forms within each chart were recorded, amounting to 18,654 physical pages and using 165 of the different forms. The average in-patient encounter within the model was 130.4 pages long, with a minimum of 27 pages, a maximum of 559 pages, and containing on average 25.8 different forms. The duplication of data fields within actual charts followed a pattern similar to the duplication found on the forms. Initial diagnosis was present on an average of 20.4 pages within the charts, with a minimum of 2 pages and a maximum of 152 pages containing this data field. Other frequently occurring data fields included History of Past Illness present on an average of 12.2 pages per chart, History of present illness on 10.2 pages per chart, and allergies on an average of 9.1 pages per chart. The results obtained through the examination of Sunnybrook charts should be generalizable to most paper-based systems. This study did not measure the workload associated with duplicating chart data. however, the magnitude of the duplication seen in this study leaves little doubt that significant amounts of time could be saved with appropriate modification of health care delivery processes. Multiple copies of the same data field within a database are referred to as aliases of each other. This study demonstrates that hospital charts contain many copies of the same information, such as medication lists, allergies etc. Due to manual replication of data fields, there is no mechanism to ensure that each copy of a data element within a chart actually contains the same information. This aliasing of data through manual duplication compromises the integrity of data within paper-based charts. Decisions and therapy based upon contradictory or inaccurate data are likely to lead to inefficient or erroneous care delivery; this has significant implications for hospital liability and quality of patient care. A growing recognition of the costs and risks of data replication within paper-based charting systems is driving the healthcare industry toward Electronic Patient Record systems. Better quality patient care data, provided by computerized records, is likely to be necessary but not sufficient to improving the efficiency and effectiveness of the healthcare system. Intelligent application of this information will be essential.

Medical Records↗
PubMed1997

DNA extraction from liquid blood using QIAamp.

The implementation of convicted felon DNA databases by increasing numbers of forensic science laboratories has engendered the need for a quick, efficient, and cost-effective method for the isolation of DNA from liquid blood samples. Because of the large numbers of samples involved, the ideal method would combine high throughput capability with maximal yield, high quality, and minimal time. We have found that the QIAGEN QIAamp Blood Kit/Tissue Kit satisfy all of these requirements. This simple, low cost spin column procedure yields purified DNA of approximately 20-30 kb that can be used directly in PCR or other enzymatic reactions without further purification. We compared the QIAamp isolation procedure to the standard SDS-Proteinase K/organic extraction/microcon purification procedure currently used by many forensic laboratories. The QIAamp procedure consistently gave a two- to four-fold increased yield relative to the organic extraction procedure. The DNA obtained was of high molecular weight, exhibited little degradation, and was suitable for RFLP and PCR analyses. We have found QIAGEN's QIAamp DNA isolation procedure to be ideally suited for preparation of samples for DNA databasing.

DNA↗
PubMed1990

The key scientific issue of the next century: the science of addiction.

The problem of addiction is believed to be the most important scientific issue of the next century. The solution to the riddle of pharmacologic, psychological, and social addiction to nicotine, heroin, alcohol, and a high-fat diet, and the discovery and implementation of strategies for spreading healthy "addictions" will aid in solving many major public health and social science problems in the next century. All-out efforts should be expended on the comprehensive development of a science of addiction and to the wide-scale effective application of the results of such research in order to promote health, prosperity, and peace for every community in the world.

Forecasting↗
PubMed1996

Year one of HIV prevention community planning: a national perspective on accomplishments, challenges, and future directions.

Two of the most important principles for the implementation of successful human immunodeficiency virus (HIV) prevention programs are the following: (a) planning for the programs must be done in conjunction with members of affected communities; and (b) the foundation of the programs should consist of solid behavioral, social, and epidemiological science. In 1994, the Centers for Disease Control and Prevention and its prevention partners formally implemented HIV prevention community planning in order to address these two key factors. The occasion of the one year anniversary of HIV prevention community planning is marked by taking stock of progress-to-date from a national perspective. This article reviews year one accomplishments and difficulties, and describes the trajectory of HIV prevention community planning for year two and beyond.

Centers for Disease Control and Prevention, U.S.↗
PubMedDate not supplied

Co-teaching as science in the schoolhouse: more questions than answers.

The concept of science in the schoolhouse combines knowledge of research-based practices with the complexities of day-to-day life in schools. In this discussion, co-teaching is offered as an example of how advocacy for a practice can outpace the science that supports it. There is a push for co-teaching in contemporary schools, and special educators in great numbers are being asked to join with general educators in meeting the needs of students with disabilities. However, the science behind co-teaching to date is very limited. Studies have examined the implementation of co-teaching as a general service delivery option, but much less attention has been paid scientifically to the character and quality of the co-taught instruction or to the impact of co-teaching on student outcomes. Within this context, I also examine how Crockett's four recommendations to support science in the schoolhouse could address the questions about co-teaching for which there are few answers.

Humans↗
PubMed1999

PROFILE: Environmental Impact Assessment Under the National Environmental Policy Act and the Protocol on Environmental Protection to the Antarctic Treaty.

/ Antarctica has been set aside by the international community for protection as a natural reserve and a place for scientific research. Through the Antarctic Treaty of 1961, the signing nations agreed to cooperate in protecting the antarctic environment, in conducting scientific studies, and in abstaining from the exercise of territorial claims. The 1991 signing of the Protocol on Environmental Protection to the Antarctic Treaty (Protocol) by representatives of the 26 nations comprising the Antarctic Treaty Consultative Parties (Parties) significantly strengthened environmental protection measures for the continent. The Protocol required ratification by each of the governments individually prior to official implementation. The US government ratified the Protocol by passage of the Antarctic Science, Tourism, and Conservation Act of 1997. Japan completed the process by ratifying the Protocol on December 15, 1997. US government actions undertaken in Antarctica are subject to the requirements of both the Protocol and the US National Environmental Policy Act (NEPA). There are differences in the scope and intent of the Protocol and NEPA; however, both require environmental impact assessment (EIA) as part of the planning process for proposed actions that have the potential for environmental impacts. In this paper we describe the two instruments and highlight key similarities and differences with particular attention to EIA. Through this comparison of the EIA requirements of NEPA and the Protocol, we show how the requirements of each can be used in concert to provide enhanced environmental protection for the antarctic environment. NEPA applies only to actions of the US government; therefore, because NEPA includes certain desirable attributes that have been refined and clarified through numerous court cases, and because the Protocol is just entering implementation internationally, some recommendations are made for strengthening the procedural requirements of the Protocol for activities undertaken by all Parties in Antarctica. The Protocol gives clear and strong guidance for protection of specific, valued antarctic environmental resources including intrinsic wilderness and aesthetic values, and the value of Antarctica as an area for scientific research. That guidance requires a higher standard of environmental protection for Antarctica than is required in other parts of the world. This paper shows that taken together NEPA and the Protocol call for closer examination of proposed actions and a more rigorous consideration of environmental impacts than either would alone. Three areas are identified where the EIA provisions of the Protocol could be strengthened to improve its effectiveness. First, the thresholds defined by the Protocol need to be clarified. Specifically, the meanings of the terms "minor" and "transitory" are not clear in the context of the Protocol. The use of "or" in the phrase "minor or transitory" further confuses the meaning. Second, cumulative impact assessment is called for by the Protocol but is not defined. A clear definition could reduce the chance that cumulative impacts would be given inadequate consideration. Finally, the public has limited opportunities to comment on or influence the preparation of initial or comprehensive environmental evaluations. Experience has shown that public input to environmental documents has a considerable influence on agency decision making and the quality of EIA that agencies perform.KEY WORDS: Environment; Impact assessment; Antarctica; NEPA; Protocol; Antarctic Treatyhttp://link.springer-ny.com/link/service/journals/00267/bibs/24n1p13.html

Journal Article↗
PubMed2007

An agency capacity model to facilitate implementation of evidence-based behavioral interventions by community-based organizations.

The Centers for Disease Control and Prevention (CDC) implemented the Diffusion of Effective Behavioral Interventions Project to disseminate evidence-based behavioral interventions to community-based HIV prevention providers. Through development of intervention-specific technical assistance guides and provision of face-to-face, telephone, and e-mail technical assistance, a range of capacity-building issues were identified. These issues were linked to a proposed agency capacity model for implementing an evidence-based intervention. The model has six domains: organizational environment, governance, and programmatic infrastructure; workforce and professional development; resources and support; motivational forces and readiness; learning from experience; and adjusting to the external environment. We think this model could be used to implement evidence-based interventions by facilitating the selection of best-prepared agencies and by identifying critical areas of capacity building. The model will help us establish a framework for informing future program announcements and predecisional site visit assessments, and in developing an instrument for assessing agency capacity to implement evidence-based interventions.

Centers for Disease Control and Prevention, U.S.↗
PubMed1998

The implementation of an integrated on-line health education system at RMIT.

The Faculty of Biomedical and Health Sciences at RMIT has been developing an on-line health education system using a systems thinking approach, to create a learning environment whose basis is supported by Information Technology (IT). The centre-piece of this system is the Faculty Learning Centre, which has been created, both in space and layout, to promote collaborative learning between the students, so that the educator is physically assimilated with the student body. This facility is supplemented by the Faculty WWW server, which has been the main vehicle for course material dissemination to students. To ensure an effective on-line teaching environment, the position of an on-line facilitator has been created, whose responsibilities include both the continual evaluation of the system and the implementation of appropriate system changes. Aspects have included the production of a staff development training program and extensive user documentation. This paper discusses the systems thinking approach used to implement this integrated on-line system, and the establishment of explicit educational rationales in the use of IT to support learning strategies. Some examples of the on-line educational programs are also presented.

Australia↗
PubMed2000

AutoDep: a web-based system for deposition and validation of macromolecular structural -information.

This paper describes the design and full implementation of a new concept in data deposition and validation: AutoDep (copyright Brookhaven Science Associates LLC). AutoDep changes the traditional procedure for data acceptance and validation of the primary databases into an interactive depositor-driven operation which almost eliminates the delay between the acceptance of the data and its public release. The system takes full advantage of the knowledge and expertise of the experimenters, rather than relying on the database curators for the complete and accurate description of the structural experiment and its results. AutoDep, developed by the Protein Data Bank at Brookhaven National Laboratory (BNL) as a flexible and portable system, has already been adopted by other primary databases and implemented on different platforms/operating systems. AutoDep was introduced at BNL in 1996 [see Manning (1996), Protein Data Bank Quart. Newslett. 77, 2 (ftp://ftp.rcsb. org/pub/pdb/doc/newsletters/bnl/newsletter96jul/newslttr+ ++.txt); Manning (1996), Protein Data Bank Quart. Newslett. 78, 2 (ftp://ftp. rcsb.org/pub/pdb/doc/newsletters/bnl/newsletter96oct/+ ++newslttr.txt)].

Computer Security↗
PubMed2001

[Policy science and health policy].

Policy science provides the analytical frameworks to examine (1) the process of policy formation and implementation (Issue definition, Agenda setting, Alternative development, Decision and implementation, and Appraisal); (2) the initial and final shapes of policy content (Temporal and special distribution of costs and benefits, Selection of administrative organizations, and Choice of instruments to secure policy compliance); and (3) the effects and efficiencies of policy (Expected and unexpected effects of policy, beneficial and adverse ones). These three aspects are closely associated, and determine the functions of policy in society. Overseas, the application of policy science framework to health issues has thus far produced substantive knowledge which helps to improve both the policy making and policy designs, and at the same time, has provided good opportunities on which the workings of health and policy, both at the social and individual levels, are explored. The paper first outlines the themes and frameworks of political science, and then, introduces their application to the field of health. Issues associated with human life and health have special characteristics that distinguish them from those of other market commodities: special values placed on life and health, information inequality between service providers and consumers, and externalities, leading to a variety of moral hazards and market failures. Furthermore, there are some conflicts in values and technical opinions in society, regarding both the ends and means of health policies. In addition to the main topics in the field, empirical studies, from Japan or from other countries, are also summarized. Finally, future research needs and expectations are addressed.

Efficiency, Organizational↗
PubMed2002

Defining "adverse environmental impact" and making paragraph 316(b) decisions: a fisheries management approach.

The electric utility industry has developed an approach for decisionmaking that includes a definition of Adverse Environmental Impact (AEI) and an implementation process. The definition of AEI is based on lessons from fishery management science and analysis of the statutory term "adverse environmental impact" and is consistent with current natural resource management policy. The industry has proposed a definition focusing on "unacceptable risk to the population"s ability to sustain itself, to support reasonably anticipated commercial or recreational harvests, or to perform its normal ecological function." This definition focuses not on counting individual fish or eggs cropped by the various uses of a water body, but on preserving populations of aquatic organisms and their functions in the aquatic community. The definition recognizes that assessment of AEI should be site-specific and requires both a biological decision and a balancing of diverse societal values. The industry believes that the definition of AEI should be implemented in a process that will maximize the overall societal benefit of the paragraph 316(b) decision by considering the facility"s physical location, design, and operation, as well as the local biology. The approach considers effects on affected fish and shellfish populations and the benefits of any necessary best technology available (BTA) alternatives. This is accomplished through consideration of population impacts, which conversely allows consideration of the benefits of any necessary BTA modifications. This in turn allows selection of BTAs that will protect potentially affected populations in a cost-effective manner. The process also employs risk assessment with stakeholder participation, in accordance with EPA's Guidelines for Ecological Risk Assessment. The information and tools are now available to make informed decisions about site-specific impacts that will ensure protection of aquatic ecosystems and best serve the public interest.

Animals↗
PubMed1995

[Assessment of strategies of science and technology management: a case study].

The Health Department of the State of S. Paulo has implemented a management strategy on research and development (R&D) for its research institutes which comprises three different items: 1) project registration, 2) support and 3) promotion of R&D activities. The present study explores the ability of this R&D management system to provide information and evaluates the performance of the third item which has been responsible for the assignment of research grants to professionals whose projects are selected through a peer review. The assessment of the grant's distribution was conducted by comparing the mean scientific production recorded in literature data bases for grant holders and equal an number of controls matched by institute of origin. The ability of the system to produce information was studied by the application of Cluster Analysis. The results show that grant holders have a scientific production significantly higher than their controls. Concerning information production, it is shown that proper raw data processing may render suggestions for decision making and that the institutes may be grouped in clusters of those that adopt similar management strategies.

Academies and Institutes↗
PubMed2004

Cancer screening.

Cancer screening is a complicated science. Each screening intervention must be carefully assessed before it is widely implemented. A screening test can falsely appear useful as it finds disease at an early stage and leads to intervention and cure. Such a test can be harmful to the population screened if it commonly finds disease that fulfills the pathologic criteria of cancer but behaves indolently (meaning it would never harm the host). Such "pseudo-disease" or "overdiagnosed disease" has been demonstrated in many malignancies including cancers of the lung, breast, and especially the prostate. The nature of each specific screening test and each disease is such that some screened patients may receive unnecessary treatment with all its complications and risk. Alternatively, some screening technologies have been proven useful providing net benefit to the population screened. Often these beneficial technologies are underused. These screening technologies if widely implemented have the potential of saving countless lives. Many available screening tests have tremendous potential in terms of benefit, but have yet to be fully assessed. At the minimum, patients should be informed of what is known, what is not known, and what is believed about these tests.

Humans↗
PubMed2004

Regulation of vaccines: strengthening the science base.

This paper aims to review the history of development of vaccine regulatory approaches, to assess practices that may be barriers to access to innovative products, and to suggest possible approaches to address these practices. Despite the appearance of new vaccines in the past few years, many vaccines are based on old technologies, and are still subject to regulatory practices devised many years ago. Vaccine regulation began with a foundation on vaccine testing, and only in response to tragedies associated with vaccine use did new concepts begin to be defined. Vaccine regulation now includes a range of functions that cover the entire continuum of vaccine development and use. However, some regulatory practices, such as the continuing dependence on outdated animal tests, have not kept pace with these changes. Other practices, such as the continual raising of the standard of Good Manufacturing Practice (GMP) compliance, or the move to increasingly larger phase 3 clinical trials, appear to be based more on perceived risks than on firm scientific principles. The future of effective regulation for vaccines that will allow innovation while protecting the public health must be based on three guiding principles: a firm science base for policies and decisions, a risk-based approach to implementation of regulatory oversight, and support for regulatory research to inform these activities. These should be implemented in a setting of international harmonization.

Cost-Benefit Analysis↗
PubMed2025

ConceptDrift: leveraging spatial, temporal and semantic evolution of biomedical concepts for hypothesis generation.

MOTIVATION: Hypothesis generation is a fundamental problem in biomedical text mining that aims to generate ideas that are new, interesting, and plausible by discovering unexplored links between biomedical concepts. Despite significant advances made by existing approaches, they do not fully leverage the evolutionary properties of biomedical concepts. This is limiting because scientific knowledge continually evolves over time, with new facts being added and old ones becoming obsolete. Thus, it is crucial to capture the evolutionary properties of biomedical concepts from multiple perspectives (e.g. spatial, temporal, and semantic) to generate hypotheses that reflect the up-to-date information landscape of the biomedical domain. RESULTS: We introduce a novel framework, ConceptDrift, that models the hypothesis generation task as a sequence of temporal graphlets and simultaneously encodes spatial, temporal, and semantic change. Unlike existing approaches that treat these dimensions independently, ConceptDrift is the first to provide a holistic understanding of concept evolution by integrating them into a unified framework. Grounded in the theories of the Distributional Hypothesis and Conceptual Change, our method adapts these principles to the unique challenges of large-scale biomedical literature. We conduct extensive experiments across multiple datasets and demonstrate that ConceptDrift consistently outperforms state-of-the-art baselines in generating accurate and meaningful hypotheses. Our framework shows immediate practical benefits for web-based literature mining tools in life sciences and biomedicine, offering more robust and predictive feature representations. AVAILABILITY AND IMPLEMENTATION: https://github.com/amir-hassan25/ConceptDrift (DOI: 10.6084/m9.figshare.29975476).

Semantics↗
PubMed1976

Social work training of new health professionals.

The Child Health Associate program provides a model for using social workers in the training of new health professionals. Administratively, social workers have contributed to curriculum development in the behavioral sciences. They have influenced decisions regarding student selection and have developed and implemented a faculty adviser program. Because of their practical experience as primary care practitioners, social workers have been able to define effectively the skills needed by the new professionals to meet the social and emotional needs of their patients. Social workers have made use of their contacts in hospitals and communities to design and implement courses and clinics that combine in a meaningful manner theoretical material and practical experiences in patient contact. Evaluative research in the area of interviewing skills and crisis management demonstrates that the teaching methods applied by the social work profession are effective in increasing the level of students' interviewing skills in clinical practice and help prepare them to recognize familiy crises.

Colorado↗
PubMed2006

Clinical rotation in pathology: description of a case based approach.

BACKGROUND: The implementation of a system based, integrated curriculum at the Faculty of Health Sciences of Stellenbosch University, Western Cape, South Africa, resulted in less contact time for the pathology disciplines during theoretical modules, while a weekly rotation in pathology was introduced during clinical training in the fourth and fifth years. OBJECTIVE: To describe a problem based approach for this rotation. METHODS: Students are presented with a clinical "paper" case daily, integrating as many of the pathology disciplines as possible to demonstrate the interdependence of the various disciplines. They receive chemical pathology tutorials, visit the various laboratories, and receive practical training in fine needle aspiration biopsy. On the final day, the case studies are assessed and discussed. RESULTS: Most students appreciated all activities. This rotation enhanced student interactivity and autonomy and guaranteed immediate feedback. On evaluation of the rotation it was found that the students enjoyed the rotation, learnt something new, and realised the value of group work. CONCLUSIONS: This innovation integrates pathology with clinical practice and illustrates the use of laboratory medicine in the management of common diseases seen in this country. Students appreciate learning practical skills and having to request special investigations under a pathologist's supervision changes their approach to pathology requests. Familiarity with the pathology environment empowers the student to use pathology with greater ease. A bank of case studies that can be expanded to include all medical disciplines will facilitate the application of a problem based approach and enhance communication between the basic science disciplines and the clinical and pathology disciplines.

Biopsy, Fine-Needle↗